Nictiz · alayabenbelkacem · Jan 22, 2025 · Jan 23, 2025 · Jan 23, 2025 · Jan 23, 2025
diff --git a/known-issues.yml b/known-issues.yml
@@ -200,6 +200,95 @@ zib-HealthProfessional-PractitionerRole:
       - datatype: ContactPoint instead of container
         reason: Contact information in FHIR is represented using the ContactPoint datatype, not as a BackboneElement.
 
+zib-InstructionsForUse:
+  zib deviations:
+    Dosage.timing:
+      - datatype: Timing instead of container
+        for: NL-CM:9.12.19948 (InstructionsForUse.AdministeringSchedule)
+        reason: AdministeringSchedule in FHIR is represented using the Timing datatype, not as a BackboneElement.
+    Dosage.timing.repeat.count:
+      - datatype: PositiveInt instead of Reference
+        for: NL-CM:9.12.19949 (InstructionsForUse.Frequency)
+        reason: A range in FHIR is represented using the positiveInt datatype, not as a separate resource.
+      - datatype: PositiveInt instead of PQ
+        for: NL-CM:20.1.2 (Range.MinimumValue)
+        reason: A value in FHIR is represented using the positiveInt datatype, not as a PQ.
+      - datatype: PositiveInt instead of PQ
+        for: NL-CM:20.1.4 (Range.NominalValue)
+        reason: A value in FHIR is represented using the positiveInt datatype, not as a PQ.
+    Dosage.timing.repeat.countMax:
+      - datatype: PositiveInt instead of Reference
+        for: NL-CM:9.12.19949 (InstructionsForUse.Frequency)
+        reason: A range in FHIR is represented using the positiveInt datatype, not as a separate resource.
+      - datatype: PositiveInt instead of Reference
+        for: NL-CM:20.1.3 (Range.MaximumValue)
+        reason: A value in FHIR is represented using the positiveInt datatype, not as a separate resource.
+    Dosage.timing.repeat.duration:
+      - datatype: Decimal instead of Reference
+        for: NL-CM:9.12.23141 (InstructionsForUse.DurationOfAdministration)
+        reason: An interval in FHIR is represented using the decimal datatype, not as a separate resource.
+    Dosage.timing.repeat.durationUnit:
+      - datatype: Code instead of Reference
+        for: NL-CM:9.12.23141 (InstructionsForUse.DurationOfAdministration)
+        reason: An interval in FHIR is represented using the code datatype, not as a separate resource.
+    Dosage.timing.repeat.frequency:
+      - datatype: PositiveInt instead of Reference
+        for: NL-CM:9.12.19949 (InstructionsForUse.Frequency)
+        reason: A range in FHIR is represented using the positiveInt datatype, not as a separate resource.
+      - datatype: PositiveInt instead of PQ
+        for: NL-CM:20.1.2 (Range.MinimumValue)
+        reason: A value in FHIR is represented using the positiveInt datatype, not as a PQ.
+      - datatype: PositiveInt instead of PQ
+        for: NL-CM:20.1.4 (Range.NominalValue)
+        reason: A value in FHIR is represented using the positiveInt datatype, not as a PQ.
+      - datatype: PositiveInt instead of PQ
+        for: NL-CM:9.12.19950 (InstructionsForUse.Interval)
+        reason: An interval in FHIR is represented using the positiveInt datatype, not as a PQ.
+    Dosage.timing.repeat.frequencyMax:
+      - datatype: PositiveInt instead of Reference
+        for: NL-CM:9.12.19949 (InstructionsForUse.Frequency)
+        reason: A range in FHIR is represented using the positiveInt datatype, not as a separate resource.
+      - datatype: PositiveInt instead of PQ
+        for: NL-CM:20.1.3 (Range.MaximumValue)
+        reason: A value in FHIR is represented using the positiveInt datatype, not as a PQ.
+    Dosage.timing.repeat.period:
+      - datatype: Decimal instead of Reference
+        for: NL-CM:9.12.19949 (InstructionsForUse.Frequency)
+        reason: A range in FHIR is represented using the decimal datatype, not as a separate resource.
+      - datatype: Decimal instead of PQ
+        for: NL-CM:9.12.19950 (InstructionsForUse.Frequency)
+        reason: A range in FHIR is represented using the decimal datatype, not as a PQ.
+    Dosage.timing.repeat.periodUnit:
+      - datatype: Code instead of Reference
+        for: NL-CM:9.12.19949 (InstructionsForUse.Frequency)
+        reason: A range in FHIR is represented using the code datatype, not as a separate resource.
+      - datatype: Code instead of PQ
+        for: NL-CM:9.12.19950 (InstructionsForUse.Frequency)
+        reason: An interval in FHIR is represented using the code datatype, not as a PQ.
+    Dosage.timing.repeat.timeOfDay:
+      - datatype: Time instead of TS
+        for: NL-CM:9.12.19951 (InstructionsForUse.AdministrationTime)
+        reason: A time in FHIR is represented using the time datatype, not as a TS.
+    Dosage.asNeeded[x]:asNeededCodeableConcept:
+      - cardinality: 0..1 instead of 0..*
+        reason: The value can only occur once, but this profile is also referenced 0..* times via .extension:asNeeded, making the effective cardinality 0..* as required by the zib.
+    Dosage.doseAndRate:
+      - datatype: Element instead of container
+        for: NL-CM:9.12.19935 (InstructionsForUse.Dosage)
+        reason: Dosage in FHIR is represented using the Element datatype, not as a BackboneElement.
+    Dosage.doseAndRate.dose[x]:
+      - datatype: Range instead of Reference
+        for: NL-CM:9.12.19940 (InstructionsForUse.Dose)
+        reason: A range in FHIR is represented using the range datatype, not as a separate resource.
+    Dosage.doseAndRate.rate[x]:
+      - datatype: Range instead of Reference
+        for: NL-CM:9.12.19942 (InstructionsForUse.AdministeringSpeed)
+        reason: A range in FHIR is represented using the ratio datatype, not as a separate resource.
+    Dosage.maxDosePerPeriod:
+      - datatype: Ratio instead of PQ
+        for: NL-CM:9.12.19946 (InstructionsForUse.MaximumDose)
+        reason: A dose in FHIR is represented using the ratio datatype, not as a PQ.
+
 zib-NameInformation:
   zib deviations:
     HumanName.family.extension:*.value[x]:

diff --git a/nl-core/StructureDefinitions/nl-core-InstructionsForUse.xml b/nl-core/StructureDefinitions/nl-core-InstructionsForUse.xml
@@ -0,0 +1,42 @@
+<?xml version="1.0" encoding="utf-8"?>
+<StructureDefinition xmlns="http://hl7.org/fhir">
+  <id value="nl-core-InstructionsForUse" />
+  <text>
+    <status value="empty" /><div xmlns="http://www.w3.org/1999/xhtml">No narrative is provided for definitional resources. A human-readable rendering can be found in the implementation guide(s) where this resource is used.</div></text>
+  <url value="http://nictiz.nl/fhir/StructureDefinition/nl-core-InstructionsForUse" />
+  <name value="NlcoreInstructionsForUse" />
+  <title value="nl core InstructionsForUse" />
+  <status value="draft" />
+  <publisher value="Nictiz" />
+  <contact>
+    <name value="Nictiz" />
+    <telecom>
+      <system value="url" />
+      <value value="https://www.nictiz.nl" />
+      <use value="work" />
+    </telecom>
+  </contact>
+  <description value="Instructions for the use or administration of the medication, e.g. dose and route of administration. In the event of medication use, this is the pattern of use established by the patient or which the patient followed." />
+  <purpose value="A derived profile from [zib-InstructionsForUse](http://nictiz.nl/fhir/StructureDefinition/zib-InstructionsForUse) to provide a version better suited for implementation purposes. This profile augments the base profile with elements found in the various use cases that have adopted the zib." />
+  <copyright value="Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise." />
+  <fhirVersion value="4.0.1" />
+  <mapping>
+    <identity value="zib-instructionsforuse-v3.0-2024EN" />
+    <uri value="https://zibs.nl/wiki/InstructionsForUse-v3.0(2024EN)" />
+    <name value="zib InstructionsForUse-v3.0(2024EN)" />
+  </mapping>
+  <kind value="complex-type" />
+  <abstract value="true" />
+  <type value="Dosage" />
+  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Dosage" />
+  <derivation value="constraint" />
+  <differential>
+    <element id="Dosage">
+      <path value="Dosage" />
+      <short value="DosingInstructions" />
+      <definition value="Dosing instructions" />
+      <comment value="This element _mostly_ represents the DosingInstructions container from zib InstructionsForUse, but also includes the AdditionalInstructions and RouteOfAdministration concepts, which are normally placed on the same level as this container. As a result, these concepts are **duplicated** in every repetition of this element, even though these concepts should be present just once according to the zib.&#xD;&#xA;&#xD;&#xA;This element does not contain a mapping to the Dosage container from zib InstructionsForUse. However, all child concepts of the Dosage concept are mapped. If an instance of zib container DosingInstructions contains multiple Dosage containers, each of these results in a separate instance of the FHIR Dosage data type conforming to this profile, wherein `.sequence` (zib concept SequenceNumber) and `.timing.repeat.bounds[x]:boundsDuration` (zib concept DoseDuration) are equal." />
+      <alias value="Doseerinstructie" />
+    </element>
+  </differential>
+</StructureDefinition>
diff --git a/release-notes.md b/release-notes.md
@@ -150,6 +150,10 @@
 ### zib-IllnessPerception.PatientIllnessInsight, nl-core-IllnessPerception.PatientIllnessInsight
 * No significant changes.
 
+## InstructionsForUse
+### zib-InstructionsForUse, nl-core-InstructionsForUse
+* No significant changes.
+
 ## LanguageProficiency (zib-Patient, nl-core-Patient)
 * `.communication.extension:languageControl.extension:level.value[x]` ; terminology ; Changed codes in TaalvaardigheidBegrijpenCodelijst, TaalvaardigheidLezenCodelijst and TaalvaardigheidSprekenCodelijst, changed value set from v3.LanguageAbilityProficiency to TaalvaardigheidCodelijsten. ; ZIB-1877
 * `.communication.extension:comment` ; extension ; Replaced extension ExtComment with ExtLanguageProficiencyComment. ; ZIBFHIR-97

diff --git a/...uctureDefinitions/ext-InstructionsForUse.MedicationDispense.RenderedDosageInstruction.xml b/...uctureDefinitions/ext-InstructionsForUse.MedicationDispense.RenderedDosageInstruction.xml
@@ -0,0 +1,63 @@
+<?xml version="1.0" encoding="utf-8"?>
+<StructureDefinition xmlns="http://hl7.org/fhir">
+  <id value="ext-InstructionsForUse.MedicationDispense.RenderedDosageInstruction" />
+  <text>
+    <status value="empty" /><div xmlns="http://www.w3.org/1999/xhtml">No narrative is provided for definitional resources. A human-readable rendering can be found in the implementation guide(s) where this resource is used.</div></text>
+  <url value="http://nictiz.nl/fhir/5.0/StructureDefinition/extension-MedicationDispense.renderedDosageInstruction" />
+  <name value="ExtInstructionsForUseMedicationDispenseRenderedDosageInstruction" />
+  <title value="ext InstructionsForUse.MedicationDispenseRendered.DosageInstruction" />
+  <status value="active" />
+  <publisher value="Nictiz" />
+  <contact>
+    <name value="Nictiz" />
+    <telecom>
+      <system value="url" />
+      <value value="https://www.nictiz.nl" />
+      <use value="work" />
+    </telecom>
+  </contact>
+  <description value="Pre-adopt of the `.renderedDosageInstructions` concept from the FHIR R5 medication resources. It provides a full representation of the dose of the medication included in all dosage instructions. To be used when multiple dosage instructions are included to represent complex dosing such as increasing or tapering doses." />
+  <copyright value="Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise." />
+  <fhirVersion value="4.0.1" />
+  <kind value="complex-type" />
+  <abstract value="false" />
+  <context>
+    <type value="element" />
+    <expression value="MedicationRequest" />
+  </context>
+  <context>
+    <type value="element" />
+    <expression value="MedicationDispense" />
+  </context>
+  <context>
+    <type value="element" />
+    <expression value="MedicationStatement" />
+  </context>
+  <type value="Extension" />
+  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
+  <derivation value="constraint" />
+  <differential>
+    <element id="Extension">
+      <path value="Extension" />
+      <definition value="Pre-adopt from FHIR R5 of the `.renderedDosageInstruction` element found in various medication resources." />
+      <max value="1" />
+    </element>
+    <element id="Extension.url">
+      <path value="Extension.url" />
+      <fixedUri value="http://nictiz.nl/fhir/StructureDefinition/ext-RenderedDosageInstruction" />
+    </element>
+    <element id="Extension.value[x]">
+      <path value="Extension.value[x]" />
+      <definition value="The full representation of the dose of the medication included in all dosage instructions. To be used when multiple dosage instructions are included to represent complex dosing such as increasing or tapering doses." />
+      <comment value="The content of the rendered dosage instruction must not be different from the dose represented in the dosage instructions content." />
+      <type>
+        <code value="string" />
+      </type>
+      <mapping>
+        <identity value="zib-instructionsforuse-v3.0-2024EN" />
+        <map value="NL-CM:9.12.9581" />
+        <comment value="Description" />
+      </mapping>
+    </element>
+  </differential>
+</StructureDefinition>
diff --git a/...ructureDefinitions/ext-InstructionsForUse.MedicationRequest.RenderedDosageInstruction.xml b/...ructureDefinitions/ext-InstructionsForUse.MedicationRequest.RenderedDosageInstruction.xml
@@ -0,0 +1,63 @@
+<?xml version="1.0" encoding="utf-8"?>
+<StructureDefinition xmlns="http://hl7.org/fhir">
+  <id value="ext-InstructionsForUse.MedicationRequest.RenderedDosageInstruction" />
+  <text>
+    <status value="empty" /><div xmlns="http://www.w3.org/1999/xhtml">No narrative is provided for definitional resources. A human-readable rendering can be found in the implementation guide(s) where this resource is used.</div></text>
+  <url value="http://nictiz.nl/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction" />
+  <name value="ExtInstructionsForUseMedicationRequestRenderedDosageInstruction" />
+  <title value="ext InstructionsForUse.MedicationRequestRendered.DosageInstruction" />
+  <status value="active" />
+  <publisher value="Nictiz" />
+  <contact>
+    <name value="Nictiz" />
+    <telecom>
+      <system value="url" />
+      <value value="https://www.nictiz.nl" />
+      <use value="work" />
+    </telecom>
+  </contact>
+  <description value="Pre-adopt of the `.renderedDosageInstructions` concept from the FHIR R5 medication resources. It provides a full representation of the dose of the medication included in all dosage instructions. To be used when multiple dosage instructions are included to represent complex dosing such as increasing or tapering doses." />
+  <copyright value="Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise." />
+  <fhirVersion value="4.0.1" />
+  <kind value="complex-type" />
+  <abstract value="false" />
+  <context>
+    <type value="element" />
+    <expression value="MedicationRequest" />
+  </context>
+  <context>
+    <type value="element" />
+    <expression value="MedicationDispense" />
+  </context>
+  <context>
+    <type value="element" />
+    <expression value="MedicationStatement" />
+  </context>
+  <type value="Extension" />
+  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
+  <derivation value="constraint" />
+  <differential>
+    <element id="Extension">
+      <path value="Extension" />
+      <definition value="Pre-adopt from FHIR R5 of the `.renderedDosageInstruction` element found in various medication resources." />
+      <max value="1" />
+    </element>
+    <element id="Extension.url">
+      <path value="Extension.url" />
+      <fixedUri value="http://nictiz.nl/fhir/StructureDefinition/ext-RenderedDosageInstruction" />
+    </element>
+    <element id="Extension.value[x]">
+      <path value="Extension.value[x]" />
+      <definition value="The full representation of the dose of the medication included in all dosage instructions. To be used when multiple dosage instructions are included to represent complex dosing such as increasing or tapering doses." />
+      <comment value="The content of the rendered dosage instruction must not be different from the dose represented in the dosage instructions content." />
+      <type>
+        <code value="string" />
+      </type>
+      <mapping>
+        <identity value="zib-instructionsforuse-v3.0-2024EN" />
+        <map value="NL-CM:9.12.9581" />
+        <comment value="Description" />
+      </mapping>
+    </element>
+  </differential>
+</StructureDefinition>