Nictiz FHIR NL STU3 Zib2017 - Local Development build (v1.3.15) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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Resource Profile: HCIM TreatmentDirective

TreatmentDirective as defined by the Dutch Health and Care Information models (Dutch: Zorginformatiebouwsteen or ZIB) version 3.1. A treatment instruction includes an agreed constraint in the treatment based on the oral or written living will of the patient.

Purpose of HCIM

A good overview of treatment instructions based on the wishes of the patient or their authorized representative on (un)desired treatments is important in a patient’s care. A concise, orderly list is of particular importance in acute care situations. Due to the large variety of symptoms, the situation concerns not only a CPR setting, but also cases in which the patient’s condition rapidly worsens as a result of existing symptoms. A healthcare provider consulting this information can discuss these existing treatment instructions with the patient, the patient’s family or the patient’s authorized representative and possibly include the instructions in their policy.

Usage:

• Examples for this Resource Profile: Consent/zib-treatmentdirective-01 and Consent/zib-treatmentdirective-02

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Consent

Name	Flags	Card.	Type	Description & Constraints
Consent	C	0..*	Consent	TreatmentDirective hcim-treatmentdirective-1: extension.additionalSources may only be used for AdvanceDirective references in addition to first reference in .source[x]
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
verification		0..*	(Complex)	Verification URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification
extension:Verified		1..1	Extension	Verified
extension:VerifiedWith		0..*	Extension	VerifiedWith
valueCodeableConcept:valueCodeableConcept		0..1	CodeableConcept	Value of extension Binding: GeverifieerdBijCodelijst (extensible): The person with whom the treatment instruction was discussed and verified.
extension:VerificationDate		0..1	Extension	VerificationDate
comment		0..1	string	Comment URL: http://nictiz.nl/fhir/StructureDefinition/Comment
treatment		0..*	(Complex)	Treatment URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment
valueCodeableConcept:valueCodeableConcept		0..1	CodeableConcept	Treatment Binding: BehandelingCodelijst (extensible): The medical treatment to which the treatment instruction applies.
additionalSources		0..*	(Complex)	Extension URL: http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources
value[x]		0..1		AdvanceDirective
valueAttachment			Attachment
valueIdentifier			Identifier
valueReference			Reference(HCIM AdvanceDirective | DocumentReference | Contract | QuestionnaireResponse)
Slices for modifierExtension		0..*	Extension	Extension Slice: Unordered, Open by value:url
modifierExtension:treatmentPermitted		1..1	Zib TreatmentDirective TreatmentPermitted	TreatmentPermitted
valueCodeableConcept:valueCodeableConcept		0..1	CodeableConcept	TreatmentPermitted Binding: BehandelingToegestaanCodelijst (extensible): Indication of permission for the treatment, no permission for the treatment, or permission for the treatment with constraints.
identifier		0..1	Identifier	Identifier for this record (external references)
status		1..1	code	draft | proposed | active | rejected | inactive | entered-in-error
category		1..*	CodeableConcept	Classification of the consent statement - for indexing/retrieval
Slices for coding		1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:treatmentDirective		1..1	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 11291000146105
display		0..1	string	Representation defined by the system
patient		1..1	Reference(nl-core-patient)	Who the consent applies to
period
start		0..1	dateTime	StartDate
end		0..1	dateTime	EndDate
dateTime		0..1	dateTime	When this Consent was created or indexed
consentingParty		0..*	Reference(nl-core-relatedperson | nl-core-organization | nl-core-patient | nl-core-practitioner)	Who is agreeing to the policy and exceptions
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
actor
reference		1..1	Reference(Device | Group | CareTeam | nl-core-organization | nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Resource for the actor (or group, by role)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
organization		0..*	Reference(nl-core-organization)	Custodian of the consent
source[x]		0..1		AdvanceDirective
sourceAttachment			Attachment
sourceIdentifier			Identifier
sourceReference			Reference(HCIM AdvanceDirective | DocumentReference | Contract | QuestionnaireResponse)
policy
uri		0..1	uri	Specific policy covered by this consent Example General Dutch Law: http://wetten.overheid.nl/
except		0..*	BackboneElement	Additional rule - addition or removal of permissions
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
restrictions		0..*	string	Restrictions URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Restrictions
type		1..1	code	deny | permit
actor
reference		1..1	Reference(Device | Group | CareTeam | nl-core-organization | nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Resource for the actor (or group, by role)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Consent.extension:verification.extension:VerifiedWith.valueCodeableConcept:valueCodeableConcept	extensible	GeverifieerdBijCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.4--20171231000000 from this IG
Consent.extension:treatment.valueCodeableConcept:valueCodeableConcept	extensible	BehandelingCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.1--20171231000000 from this IG
Consent.modifierExtension:treatmentPermitted.valueCodeableConcept:valueCodeableConcept	extensible	BehandelingToegestaanCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.2--20171231000000 from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
hcim-treatmentdirective-1	error	Consent	extension.additionalSources may only be used for AdvanceDirective references in addition to first reference in .source[x] : extension.where(url = 'http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources').empty() or source.exists()

Name	Flags	Card.	Type	Description & Constraints
Consent	C	0..*	Consent	TreatmentDirective ppc-1: Either a Policy or PolicyRule hcim-treatmentdirective-1: extension.additionalSources may only be used for AdvanceDirective references in addition to first reference in .source[x]
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
verification		0..*	(Complex)	Verification URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:Verified		1..1	Extension	Verified
url		1..1	uri	"Verified"
Slices for value[x]		0..1	boolean	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueBoolean		0..1	boolean	Verified
extension:VerifiedWith		0..*	Extension	VerifiedWith
url		1..1	uri	"VerifiedWith"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept		0..1	CodeableConcept	Value of extension Binding: GeverifieerdBijCodelijst (extensible): The person with whom the treatment instruction was discussed and verified.
extension:VerificationDate		0..1	Extension	VerificationDate
url		1..1	uri	"VerificationDate"
Slices for value[x]		0..1	dateTime	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueDateTime		0..1	dateTime	VerificationDate
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification"
comment		0..1	string	Comment URL: http://nictiz.nl/fhir/StructureDefinition/Comment
treatment		0..*	(Complex)	Treatment URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept		0..1	CodeableConcept	Treatment Binding: BehandelingCodelijst (extensible): The medical treatment to which the treatment instruction applies.
additionalSources		0..*	(Complex)	Extension URL: http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources"
value[x]		0..1		AdvanceDirective
valueAttachment			Attachment
valueIdentifier			Identifier
valueReference			Reference(HCIM AdvanceDirective | DocumentReference | Contract | QuestionnaireResponse)
Slices for modifierExtension	?!	0..*	Extension	Extension Slice: Unordered, Open by value:url
modifierExtension:treatmentPermitted	?!	1..1	Zib TreatmentDirective TreatmentPermitted	TreatmentPermitted
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-TreatmentPermitted"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept		0..1	CodeableConcept	TreatmentPermitted Binding: BehandelingToegestaanCodelijst (extensible): Indication of permission for the treatment, no permission for the treatment, or permission for the treatment with constraints.
identifier	Σ	0..1	Identifier	Identifier for this record (external references) Example General: {"system":"urn:ietf:rfc:3986","value":"Local eCMS identifier"}
status	?!Σ	1..1	code	draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent
category	Σ	1..*	CodeableConcept	Classification of the consent statement - for indexing/retrieval Binding: Consent Category Codes (example): A classification of the type of consents found in a consent statement
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:treatmentDirective	Σ	1..1	Coding	Code defined by a terminology system
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 11291000146105
display	Σ	0..1	string	Representation defined by the system
patient	Σ	1..1	Reference(nl-core-patient)	Who the consent applies to
dateTime	Σ	0..1	dateTime	When this Consent was created or indexed
consentingParty	Σ	0..*	Reference(nl-core-relatedperson | nl-core-organization | nl-core-patient | nl-core-practitioner)	Who is agreeing to the policy and exceptions
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
organization	Σ	0..*	Reference(nl-core-organization)	Custodian of the consent
source[x]	Σ	0..1		AdvanceDirective
sourceAttachment			Attachment
sourceIdentifier			Identifier
sourceReference			Reference(HCIM AdvanceDirective | DocumentReference | Contract | QuestionnaireResponse)
except	Σ	0..*	BackboneElement	Additional rule - addition or removal of permissions
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
restrictions		0..*	string	Restrictions URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Restrictions
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type	Σ	1..1	code	deny | permit Binding: ConsentExceptType (required): How an exception statement is applied, such as adding additional consent or removing consent
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Consent.extension:verification.extension:VerifiedWith.value[x]:valueCodeableConcept	extensible	GeverifieerdBijCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.4--20171231000000 from this IG
Consent.extension:treatment.value[x]:valueCodeableConcept	extensible	BehandelingCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.1--20171231000000 from this IG
Consent.modifierExtension:treatmentPermitted.value[x]:valueCodeableConcept	extensible	BehandelingToegestaanCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.2--20171231000000 from this IG
Consent.status	required	ConsentState http://hl7.org/fhir/ValueSet/consent-state-codes from the FHIR Standard
Consent.category	example	Consent Category Codes http://hl7.org/fhir/ValueSet/consent-category from the FHIR Standard
Consent.except.type	required	ConsentExceptType http://hl7.org/fhir/ValueSet/consent-except-type from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Consent	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Consent	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Consent	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Consent	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
hcim-treatmentdirective-1	error	Consent	extension.additionalSources may only be used for AdvanceDirective references in addition to first reference in .source[x] : extension.where(url = 'http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources').empty() or source.exists()
ppc-1	error	Consent	Either a Policy or PolicyRule : policy.exists() or policyRule.exists()

Name	Flags	Card.	Type	Description & Constraints
Consent	C	0..*	Consent	TreatmentDirective ppc-1: Either a Policy or PolicyRule hcim-treatmentdirective-1: extension.additionalSources may only be used for AdvanceDirective references in addition to first reference in .source[x]
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
verification		0..*	(Complex)	Verification URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:Verified		1..1	Extension	Verified
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"Verified"
Slices for value[x]		0..1	boolean	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueBoolean		0..1	boolean	Verified
extension:VerifiedWith		0..*	Extension	VerifiedWith
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"VerifiedWith"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept		0..1	CodeableConcept	Value of extension Binding: GeverifieerdBijCodelijst (extensible): The person with whom the treatment instruction was discussed and verified.
extension:VerificationDate		0..1	Extension	VerificationDate
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"VerificationDate"
Slices for value[x]		0..1	dateTime	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueDateTime		0..1	dateTime	VerificationDate
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification"
comment		0..1	string	Comment URL: http://nictiz.nl/fhir/StructureDefinition/Comment
treatment		0..*	(Complex)	Treatment URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept		0..1	CodeableConcept	Treatment Binding: BehandelingCodelijst (extensible): The medical treatment to which the treatment instruction applies.
additionalSources		0..*	(Complex)	Extension URL: http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources"
value[x]		0..1		AdvanceDirective
valueAttachment			Attachment
valueIdentifier			Identifier
valueReference			Reference(HCIM AdvanceDirective | DocumentReference | Contract | QuestionnaireResponse)
Slices for modifierExtension	?!	0..*	Extension	Extension Slice: Unordered, Open by value:url
modifierExtension:treatmentPermitted	?!	1..1	Zib TreatmentDirective TreatmentPermitted	TreatmentPermitted
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-TreatmentPermitted"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept		0..1	CodeableConcept	TreatmentPermitted Binding: BehandelingToegestaanCodelijst (extensible): Indication of permission for the treatment, no permission for the treatment, or permission for the treatment with constraints.
identifier	Σ	0..1	Identifier	Identifier for this record (external references) Example General: {"system":"urn:ietf:rfc:3986","value":"Local eCMS identifier"}
status	?!Σ	1..1	code	draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent
category	Σ	1..*	CodeableConcept	Classification of the consent statement - for indexing/retrieval Binding: Consent Category Codes (example): A classification of the type of consents found in a consent statement
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:treatmentDirective	Σ	1..1	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 11291000146105
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
patient	Σ	1..1	Reference(nl-core-patient)	Who the consent applies to
period	Σ	0..1	Period	Period that this consent applies
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
start	ΣC	0..1	dateTime	StartDate
end	ΣC	0..1	dateTime	EndDate
dateTime	Σ	0..1	dateTime	When this Consent was created or indexed
consentingParty	Σ	0..*	Reference(nl-core-relatedperson | nl-core-organization | nl-core-patient | nl-core-practitioner)	Who is agreeing to the policy and exceptions
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
actor	Σ	0..*	BackboneElement	Who|what controlled by this consent (or group, by role)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
role		1..1	CodeableConcept	How the actor is involved Binding: SecurityRoleType (extensible): How an actor is involved in the consent considerations
reference		1..1	Reference(Device | Group | CareTeam | nl-core-organization | nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Resource for the actor (or group, by role)
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
action	Σ	0..*	CodeableConcept	Actions controlled by this consent Binding: Consent Action Codes (example): Detailed codes for the consent action.
organization	Σ	0..*	Reference(nl-core-organization)	Custodian of the consent
source[x]	Σ	0..1		AdvanceDirective
sourceAttachment			Attachment
sourceIdentifier			Identifier
sourceReference			Reference(HCIM AdvanceDirective | DocumentReference | Contract | QuestionnaireResponse)
policy		0..*	BackboneElement	Policies covered by this consent
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
authority	C	0..1	uri	Enforcement source for policy
uri	C	0..1	uri	Specific policy covered by this consent Example General Dutch Law: http://wetten.overheid.nl/
policyRule	ΣC	0..1	uri	Policy that this consents to
securityLabel	Σ	0..*	Coding	Security Labels that define affected resources Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
purpose	Σ	0..*	Coding	Context of activities for which the agreement is made Binding: PurposeOfUse (extensible): What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels
dataPeriod	Σ	0..1	Period	Timeframe for data controlled by this consent
data	Σ	0..*	BackboneElement	Data controlled by this consent
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
meaning	Σ	1..1	code	instance | related | dependents | authoredby Binding: ConsentDataMeaning (required): How a resource reference is interpreted when testing consent restrictions
reference	Σ	1..1	Reference(Resource)	The actual data reference
except	Σ	0..*	BackboneElement	Additional rule - addition or removal of permissions
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
restrictions		0..*	string	Restrictions URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Restrictions
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type	Σ	1..1	code	deny | permit Binding: ConsentExceptType (required): How an exception statement is applied, such as adding additional consent or removing consent
period	Σ	0..1	Period	Timeframe for this exception
actor	Σ	0..*	BackboneElement	Who|what controlled by this exception (or group, by role)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
role		1..1	CodeableConcept	How the actor is involved Binding: SecurityRoleType (extensible): How an actor is involved in the consent considerations
reference		1..1	Reference(Device | Group | CareTeam | nl-core-organization | nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Resource for the actor (or group, by role)
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
action	Σ	0..*	CodeableConcept	Actions controlled by this exception Binding: Consent Action Codes (example): Detailed codes for the consent action.
securityLabel	Σ	0..*	Coding	Security Labels that define affected resources Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
purpose	Σ	0..*	Coding	Context of activities covered by this exception Binding: PurposeOfUse (extensible): What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels
class	Σ	0..*	Coding	e.g. Resource Type, Profile, or CDA etc Binding: Consent Content Class (extensible): The class (type) of information a consent rule covers
code	Σ	0..*	Coding	e.g. LOINC or SNOMED CT code, etc in the content Binding: Consent Content Codes (example): If this code is found in an instance, then the exception applies
dataPeriod	Σ	0..1	Period	Timeframe for data controlled by this exception
data	Σ	0..*	BackboneElement	Data controlled by this exception
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
meaning	Σ	1..1	code	instance | related | dependents | authoredby Binding: ConsentDataMeaning (required): How a resource reference is interpreted when testing consent restrictions
reference	Σ	1..1	Reference(Resource)	The actual data reference
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Consent.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Consent.extension:verification.extension:VerifiedWith.value[x]:valueCodeableConcept	extensible	GeverifieerdBijCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.4--20171231000000 from this IG
Consent.extension:treatment.value[x]:valueCodeableConcept	extensible	BehandelingCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.1--20171231000000 from this IG
Consent.modifierExtension:treatmentPermitted.value[x]:valueCodeableConcept	extensible	BehandelingToegestaanCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.2--20171231000000 from this IG
Consent.status	required	ConsentState http://hl7.org/fhir/ValueSet/consent-state-codes from the FHIR Standard
Consent.category	example	Consent Category Codes http://hl7.org/fhir/ValueSet/consent-category from the FHIR Standard
Consent.actor.role	extensible	SecurityRoleType http://hl7.org/fhir/ValueSet/security-role-type from the FHIR Standard
Consent.action	example	Consent Action Codes http://hl7.org/fhir/ValueSet/consent-action from the FHIR Standard
Consent.securityLabel	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Consent.purpose	extensible	PurposeOfUse http://hl7.org/fhir/ValueSet/v3-PurposeOfUse from the FHIR Standard
Consent.data.meaning	required	ConsentDataMeaning http://hl7.org/fhir/ValueSet/consent-data-meaning from the FHIR Standard
Consent.except.type	required	ConsentExceptType http://hl7.org/fhir/ValueSet/consent-except-type from the FHIR Standard
Consent.except.actor.role	extensible	SecurityRoleType http://hl7.org/fhir/ValueSet/security-role-type from the FHIR Standard
Consent.except.action	example	Consent Action Codes http://hl7.org/fhir/ValueSet/consent-action from the FHIR Standard
Consent.except.securityLabel	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Consent.except.purpose	extensible	PurposeOfUse http://hl7.org/fhir/ValueSet/v3-PurposeOfUse from the FHIR Standard
Consent.except.class	extensible	Consent Content Class http://hl7.org/fhir/ValueSet/consent-content-class from the FHIR Standard
Consent.except.code	example	Consent Content Codes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/consent-content-code from the FHIR Standard
Consent.except.data.meaning	required	ConsentDataMeaning http://hl7.org/fhir/ValueSet/consent-data-meaning from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Consent	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Consent	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Consent	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Consent	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
hcim-treatmentdirective-1	error	Consent	extension.additionalSources may only be used for AdvanceDirective references in addition to first reference in .source[x] : extension.where(url = 'http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources').empty() or source.exists()
ppc-1	error	Consent	Either a Policy or PolicyRule : policy.exists() or policyRule.exists()

This structure is derived from Consent

Summary

Mandatory: 6 elements(1 nested mandatory element)
Fixed: 2 elements

Structures

This structure refers to these other structures:

• HCIM AdvanceDirective (http://nictiz.nl/fhir/StructureDefinition/zib-AdvanceDirective)
• nl-core-patient (http://fhir.nl/fhir/StructureDefinition/nl-core-patient)
• nl-core-relatedperson (http://fhir.nl/fhir/StructureDefinition/nl-core-relatedperson)
• nl-core-organization (http://fhir.nl/fhir/StructureDefinition/nl-core-organization)
• nl-core-practitioner (http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner)

Extensions

This structure refers to these extensions:

• http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification
• http://nictiz.nl/fhir/StructureDefinition/Comment
• http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment
• http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources
• http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-TreatmentPermitted (Modifier)
• http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
• http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Restrictions

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Consent.category.coding

Differential View

This structure is derived from Consent

Name	Flags	Card.	Type	Description & Constraints
Consent	C	0..*	Consent	TreatmentDirective hcim-treatmentdirective-1: extension.additionalSources may only be used for AdvanceDirective references in addition to first reference in .source[x]
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
verification		0..*	(Complex)	Verification URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification
extension:Verified		1..1	Extension	Verified
extension:VerifiedWith		0..*	Extension	VerifiedWith
valueCodeableConcept:valueCodeableConcept		0..1	CodeableConcept	Value of extension Binding: GeverifieerdBijCodelijst (extensible): The person with whom the treatment instruction was discussed and verified.
extension:VerificationDate		0..1	Extension	VerificationDate
comment		0..1	string	Comment URL: http://nictiz.nl/fhir/StructureDefinition/Comment
treatment		0..*	(Complex)	Treatment URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment
valueCodeableConcept:valueCodeableConcept		0..1	CodeableConcept	Treatment Binding: BehandelingCodelijst (extensible): The medical treatment to which the treatment instruction applies.
additionalSources		0..*	(Complex)	Extension URL: http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources
value[x]		0..1		AdvanceDirective
valueAttachment			Attachment
valueIdentifier			Identifier
valueReference			Reference(HCIM AdvanceDirective | DocumentReference | Contract | QuestionnaireResponse)
Slices for modifierExtension		0..*	Extension	Extension Slice: Unordered, Open by value:url
modifierExtension:treatmentPermitted		1..1	Zib TreatmentDirective TreatmentPermitted	TreatmentPermitted
valueCodeableConcept:valueCodeableConcept		0..1	CodeableConcept	TreatmentPermitted Binding: BehandelingToegestaanCodelijst (extensible): Indication of permission for the treatment, no permission for the treatment, or permission for the treatment with constraints.
identifier		0..1	Identifier	Identifier for this record (external references)
status		1..1	code	draft | proposed | active | rejected | inactive | entered-in-error
category		1..*	CodeableConcept	Classification of the consent statement - for indexing/retrieval
Slices for coding		1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:treatmentDirective		1..1	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 11291000146105
display		0..1	string	Representation defined by the system
patient		1..1	Reference(nl-core-patient)	Who the consent applies to
period
start		0..1	dateTime	StartDate
end		0..1	dateTime	EndDate
dateTime		0..1	dateTime	When this Consent was created or indexed
consentingParty		0..*	Reference(nl-core-relatedperson | nl-core-organization | nl-core-patient | nl-core-practitioner)	Who is agreeing to the policy and exceptions
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
actor
reference		1..1	Reference(Device | Group | CareTeam | nl-core-organization | nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Resource for the actor (or group, by role)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
organization		0..*	Reference(nl-core-organization)	Custodian of the consent
source[x]		0..1		AdvanceDirective
sourceAttachment			Attachment
sourceIdentifier			Identifier
sourceReference			Reference(HCIM AdvanceDirective | DocumentReference | Contract | QuestionnaireResponse)
policy
uri		0..1	uri	Specific policy covered by this consent Example General Dutch Law: http://wetten.overheid.nl/
except		0..*	BackboneElement	Additional rule - addition or removal of permissions
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
restrictions		0..*	string	Restrictions URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Restrictions
type		1..1	code	deny | permit
actor
reference		1..1	Reference(Device | Group | CareTeam | nl-core-organization | nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Resource for the actor (or group, by role)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Consent.extension:verification.extension:VerifiedWith.valueCodeableConcept:valueCodeableConcept	extensible	GeverifieerdBijCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.4--20171231000000 from this IG
Consent.extension:treatment.valueCodeableConcept:valueCodeableConcept	extensible	BehandelingCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.1--20171231000000 from this IG
Consent.modifierExtension:treatmentPermitted.valueCodeableConcept:valueCodeableConcept	extensible	BehandelingToegestaanCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.2--20171231000000 from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
hcim-treatmentdirective-1	error	Consent	extension.additionalSources may only be used for AdvanceDirective references in addition to first reference in .source[x] : extension.where(url = 'http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources').empty() or source.exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Consent	C	0..*	Consent	TreatmentDirective ppc-1: Either a Policy or PolicyRule hcim-treatmentdirective-1: extension.additionalSources may only be used for AdvanceDirective references in addition to first reference in .source[x]
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
verification		0..*	(Complex)	Verification URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:Verified		1..1	Extension	Verified
url		1..1	uri	"Verified"
Slices for value[x]		0..1	boolean	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueBoolean		0..1	boolean	Verified
extension:VerifiedWith		0..*	Extension	VerifiedWith
url		1..1	uri	"VerifiedWith"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept		0..1	CodeableConcept	Value of extension Binding: GeverifieerdBijCodelijst (extensible): The person with whom the treatment instruction was discussed and verified.
extension:VerificationDate		0..1	Extension	VerificationDate
url		1..1	uri	"VerificationDate"
Slices for value[x]		0..1	dateTime	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueDateTime		0..1	dateTime	VerificationDate
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification"
comment		0..1	string	Comment URL: http://nictiz.nl/fhir/StructureDefinition/Comment
treatment		0..*	(Complex)	Treatment URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept		0..1	CodeableConcept	Treatment Binding: BehandelingCodelijst (extensible): The medical treatment to which the treatment instruction applies.
additionalSources		0..*	(Complex)	Extension URL: http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources"
value[x]		0..1		AdvanceDirective
valueAttachment			Attachment
valueIdentifier			Identifier
valueReference			Reference(HCIM AdvanceDirective | DocumentReference | Contract | QuestionnaireResponse)
Slices for modifierExtension	?!	0..*	Extension	Extension Slice: Unordered, Open by value:url
modifierExtension:treatmentPermitted	?!	1..1	Zib TreatmentDirective TreatmentPermitted	TreatmentPermitted
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-TreatmentPermitted"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept		0..1	CodeableConcept	TreatmentPermitted Binding: BehandelingToegestaanCodelijst (extensible): Indication of permission for the treatment, no permission for the treatment, or permission for the treatment with constraints.
identifier	Σ	0..1	Identifier	Identifier for this record (external references) Example General: {"system":"urn:ietf:rfc:3986","value":"Local eCMS identifier"}
status	?!Σ	1..1	code	draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent
category	Σ	1..*	CodeableConcept	Classification of the consent statement - for indexing/retrieval Binding: Consent Category Codes (example): A classification of the type of consents found in a consent statement
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:treatmentDirective	Σ	1..1	Coding	Code defined by a terminology system
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 11291000146105
display	Σ	0..1	string	Representation defined by the system
patient	Σ	1..1	Reference(nl-core-patient)	Who the consent applies to
dateTime	Σ	0..1	dateTime	When this Consent was created or indexed
consentingParty	Σ	0..*	Reference(nl-core-relatedperson | nl-core-organization | nl-core-patient | nl-core-practitioner)	Who is agreeing to the policy and exceptions
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
organization	Σ	0..*	Reference(nl-core-organization)	Custodian of the consent
source[x]	Σ	0..1		AdvanceDirective
sourceAttachment			Attachment
sourceIdentifier			Identifier
sourceReference			Reference(HCIM AdvanceDirective | DocumentReference | Contract | QuestionnaireResponse)
except	Σ	0..*	BackboneElement	Additional rule - addition or removal of permissions
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
restrictions		0..*	string	Restrictions URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Restrictions
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type	Σ	1..1	code	deny | permit Binding: ConsentExceptType (required): How an exception statement is applied, such as adding additional consent or removing consent
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Consent.extension:verification.extension:VerifiedWith.value[x]:valueCodeableConcept	extensible	GeverifieerdBijCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.4--20171231000000 from this IG
Consent.extension:treatment.value[x]:valueCodeableConcept	extensible	BehandelingCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.1--20171231000000 from this IG
Consent.modifierExtension:treatmentPermitted.value[x]:valueCodeableConcept	extensible	BehandelingToegestaanCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.2--20171231000000 from this IG
Consent.status	required	ConsentState http://hl7.org/fhir/ValueSet/consent-state-codes from the FHIR Standard
Consent.category	example	Consent Category Codes http://hl7.org/fhir/ValueSet/consent-category from the FHIR Standard
Consent.except.type	required	ConsentExceptType http://hl7.org/fhir/ValueSet/consent-except-type from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Consent	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Consent	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Consent	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Consent	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
hcim-treatmentdirective-1	error	Consent	extension.additionalSources may only be used for AdvanceDirective references in addition to first reference in .source[x] : extension.where(url = 'http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources').empty() or source.exists()
ppc-1	error	Consent	Either a Policy or PolicyRule : policy.exists() or policyRule.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Consent	C	0..*	Consent	TreatmentDirective ppc-1: Either a Policy or PolicyRule hcim-treatmentdirective-1: extension.additionalSources may only be used for AdvanceDirective references in addition to first reference in .source[x]
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
verification		0..*	(Complex)	Verification URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:Verified		1..1	Extension	Verified
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"Verified"
Slices for value[x]		0..1	boolean	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueBoolean		0..1	boolean	Verified
extension:VerifiedWith		0..*	Extension	VerifiedWith
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"VerifiedWith"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept		0..1	CodeableConcept	Value of extension Binding: GeverifieerdBijCodelijst (extensible): The person with whom the treatment instruction was discussed and verified.
extension:VerificationDate		0..1	Extension	VerificationDate
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"VerificationDate"
Slices for value[x]		0..1	dateTime	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueDateTime		0..1	dateTime	VerificationDate
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification"
comment		0..1	string	Comment URL: http://nictiz.nl/fhir/StructureDefinition/Comment
treatment		0..*	(Complex)	Treatment URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept		0..1	CodeableConcept	Treatment Binding: BehandelingCodelijst (extensible): The medical treatment to which the treatment instruction applies.
additionalSources		0..*	(Complex)	Extension URL: http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources"
value[x]		0..1		AdvanceDirective
valueAttachment			Attachment
valueIdentifier			Identifier
valueReference			Reference(HCIM AdvanceDirective | DocumentReference | Contract | QuestionnaireResponse)
Slices for modifierExtension	?!	0..*	Extension	Extension Slice: Unordered, Open by value:url
modifierExtension:treatmentPermitted	?!	1..1	Zib TreatmentDirective TreatmentPermitted	TreatmentPermitted
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-TreatmentPermitted"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept		0..1	CodeableConcept	TreatmentPermitted Binding: BehandelingToegestaanCodelijst (extensible): Indication of permission for the treatment, no permission for the treatment, or permission for the treatment with constraints.
identifier	Σ	0..1	Identifier	Identifier for this record (external references) Example General: {"system":"urn:ietf:rfc:3986","value":"Local eCMS identifier"}
status	?!Σ	1..1	code	draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent
category	Σ	1..*	CodeableConcept	Classification of the consent statement - for indexing/retrieval Binding: Consent Category Codes (example): A classification of the type of consents found in a consent statement
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:treatmentDirective	Σ	1..1	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 11291000146105
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
patient	Σ	1..1	Reference(nl-core-patient)	Who the consent applies to
period	Σ	0..1	Period	Period that this consent applies
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
start	ΣC	0..1	dateTime	StartDate
end	ΣC	0..1	dateTime	EndDate
dateTime	Σ	0..1	dateTime	When this Consent was created or indexed
consentingParty	Σ	0..*	Reference(nl-core-relatedperson | nl-core-organization | nl-core-patient | nl-core-practitioner)	Who is agreeing to the policy and exceptions
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
actor	Σ	0..*	BackboneElement	Who|what controlled by this consent (or group, by role)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
role		1..1	CodeableConcept	How the actor is involved Binding: SecurityRoleType (extensible): How an actor is involved in the consent considerations
reference		1..1	Reference(Device | Group | CareTeam | nl-core-organization | nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Resource for the actor (or group, by role)
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
action	Σ	0..*	CodeableConcept	Actions controlled by this consent Binding: Consent Action Codes (example): Detailed codes for the consent action.
organization	Σ	0..*	Reference(nl-core-organization)	Custodian of the consent
source[x]	Σ	0..1		AdvanceDirective
sourceAttachment			Attachment
sourceIdentifier			Identifier
sourceReference			Reference(HCIM AdvanceDirective | DocumentReference | Contract | QuestionnaireResponse)
policy		0..*	BackboneElement	Policies covered by this consent
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
authority	C	0..1	uri	Enforcement source for policy
uri	C	0..1	uri	Specific policy covered by this consent Example General Dutch Law: http://wetten.overheid.nl/
policyRule	ΣC	0..1	uri	Policy that this consents to
securityLabel	Σ	0..*	Coding	Security Labels that define affected resources Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
purpose	Σ	0..*	Coding	Context of activities for which the agreement is made Binding: PurposeOfUse (extensible): What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels
dataPeriod	Σ	0..1	Period	Timeframe for data controlled by this consent
data	Σ	0..*	BackboneElement	Data controlled by this consent
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
meaning	Σ	1..1	code	instance | related | dependents | authoredby Binding: ConsentDataMeaning (required): How a resource reference is interpreted when testing consent restrictions
reference	Σ	1..1	Reference(Resource)	The actual data reference
except	Σ	0..*	BackboneElement	Additional rule - addition or removal of permissions
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
restrictions		0..*	string	Restrictions URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Restrictions
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type	Σ	1..1	code	deny | permit Binding: ConsentExceptType (required): How an exception statement is applied, such as adding additional consent or removing consent
period	Σ	0..1	Period	Timeframe for this exception
actor	Σ	0..*	BackboneElement	Who|what controlled by this exception (or group, by role)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
role		1..1	CodeableConcept	How the actor is involved Binding: SecurityRoleType (extensible): How an actor is involved in the consent considerations
reference		1..1	Reference(Device | Group | CareTeam | nl-core-organization | nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Resource for the actor (or group, by role)
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
action	Σ	0..*	CodeableConcept	Actions controlled by this exception Binding: Consent Action Codes (example): Detailed codes for the consent action.
securityLabel	Σ	0..*	Coding	Security Labels that define affected resources Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
purpose	Σ	0..*	Coding	Context of activities covered by this exception Binding: PurposeOfUse (extensible): What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels
class	Σ	0..*	Coding	e.g. Resource Type, Profile, or CDA etc Binding: Consent Content Class (extensible): The class (type) of information a consent rule covers
code	Σ	0..*	Coding	e.g. LOINC or SNOMED CT code, etc in the content Binding: Consent Content Codes (example): If this code is found in an instance, then the exception applies
dataPeriod	Σ	0..1	Period	Timeframe for data controlled by this exception
data	Σ	0..*	BackboneElement	Data controlled by this exception
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
meaning	Σ	1..1	code	instance | related | dependents | authoredby Binding: ConsentDataMeaning (required): How a resource reference is interpreted when testing consent restrictions
reference	Σ	1..1	Reference(Resource)	The actual data reference
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Consent.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Consent.extension:verification.extension:VerifiedWith.value[x]:valueCodeableConcept	extensible	GeverifieerdBijCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.4--20171231000000 from this IG
Consent.extension:treatment.value[x]:valueCodeableConcept	extensible	BehandelingCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.1--20171231000000 from this IG
Consent.modifierExtension:treatmentPermitted.value[x]:valueCodeableConcept	extensible	BehandelingToegestaanCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.2--20171231000000 from this IG
Consent.status	required	ConsentState http://hl7.org/fhir/ValueSet/consent-state-codes from the FHIR Standard
Consent.category	example	Consent Category Codes http://hl7.org/fhir/ValueSet/consent-category from the FHIR Standard
Consent.actor.role	extensible	SecurityRoleType http://hl7.org/fhir/ValueSet/security-role-type from the FHIR Standard
Consent.action	example	Consent Action Codes http://hl7.org/fhir/ValueSet/consent-action from the FHIR Standard
Consent.securityLabel	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Consent.purpose	extensible	PurposeOfUse http://hl7.org/fhir/ValueSet/v3-PurposeOfUse from the FHIR Standard
Consent.data.meaning	required	ConsentDataMeaning http://hl7.org/fhir/ValueSet/consent-data-meaning from the FHIR Standard
Consent.except.type	required	ConsentExceptType http://hl7.org/fhir/ValueSet/consent-except-type from the FHIR Standard
Consent.except.actor.role	extensible	SecurityRoleType http://hl7.org/fhir/ValueSet/security-role-type from the FHIR Standard
Consent.except.action	example	Consent Action Codes http://hl7.org/fhir/ValueSet/consent-action from the FHIR Standard
Consent.except.securityLabel	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Consent.except.purpose	extensible	PurposeOfUse http://hl7.org/fhir/ValueSet/v3-PurposeOfUse from the FHIR Standard
Consent.except.class	extensible	Consent Content Class http://hl7.org/fhir/ValueSet/consent-content-class from the FHIR Standard
Consent.except.code	example	Consent Content Codes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/consent-content-code from the FHIR Standard
Consent.except.data.meaning	required	ConsentDataMeaning http://hl7.org/fhir/ValueSet/consent-data-meaning from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Consent	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Consent	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Consent	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Consent	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
hcim-treatmentdirective-1	error	Consent	extension.additionalSources may only be used for AdvanceDirective references in addition to first reference in .source[x] : extension.where(url = 'http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources').empty() or source.exists()
ppc-1	error	Consent	Either a Policy or PolicyRule : policy.exists() or policyRule.exists()

This structure is derived from Consent

Summary

Mandatory: 6 elements(1 nested mandatory element)
Fixed: 2 elements

Structures

This structure refers to these other structures:

• HCIM AdvanceDirective (http://nictiz.nl/fhir/StructureDefinition/zib-AdvanceDirective)
• nl-core-patient (http://fhir.nl/fhir/StructureDefinition/nl-core-patient)
• nl-core-relatedperson (http://fhir.nl/fhir/StructureDefinition/nl-core-relatedperson)
• nl-core-organization (http://fhir.nl/fhir/StructureDefinition/nl-core-organization)
• nl-core-practitioner (http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner)

Extensions

This structure refers to these extensions:

• http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification
• http://nictiz.nl/fhir/StructureDefinition/Comment
• http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment
• http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources
• http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-TreatmentPermitted (Modifier)
• http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
• http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Restrictions

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Consent.category.coding