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Name: be.en.hd.TreatmentInstruction
Version: 0.0.1
Status: Draft


DCM::ContactInformation.Address *
DCM::ContactInformation.Name *
DCM::ContactInformation.Telecom *
DCM::ContentAuthorList Clinical Building Blocks Expert Group &
DCM::CreationDate 25-10-2012
DCM::DescriptionLanguage en
DCM::Id 2.16.840.1.113883.
DCM::KeywordList advance directives, behandel aanwijzing, wilsverklaring, behandelbeperking
DCM::LifecycleStatus Draft
DCM::ModelerList Clinical Building Blocks Expert Group &
DCM::Name be.en.hd.TreatmentDirective
DCM::ReviewerList Clinical Building Blocks Expert Group &
DCM::RevisionDate 05-01-2016
DCM::Version 0.0.1

Revision History


A treatment instruction includes an agreed constraint in the treatment based on the oral or written living will of the patient.


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.

Information model

Refer to the legend page for more information about the used types and data types

rootconcept TreatmentInstruction
Definition Root concept of the TreatmentInstruction building block. This concept contains all data elements of the TreatmentInstruction building block.
Type Zib.png
DCM::DefinitionCode NL-CM:2.1.1
container Verification
Definition Container of the Verification concept. This container contains all data elements of the Verification concept.
Datatype Container.png
DCM::DefinitionCode NL-CM:2.1.8
data Verified
Definition Indication of the fact that the treatment instruction has been verified with the patient, the patient’s family and/or the patient's authorized representative.
Datatype BL.png
DCM::DefinitionCode NL-CM:2.1.9
DCM::ExampleValue Ja
data VerificationDate
Definition Date on which the verification with the patient, the patient’s family and/or the patient's authorized representative took place.
Datatype TS.png
DCM::DefinitionCode NL-CM:2.1.10
DCM::ExampleValue 11-09-2012
data Constraints
Definition The constraints or specific circumstances that apply to a certain treatment.
Datatype ST.png
DCM::DefinitionCode NL-CM:2.1.5
DCM::ExampleValue Voor intubatie eerst overleg met echtgenote
data StartDate
Definition Date on which the treatment instruction went into effect. A ‘vague’ date, such as only the year, is permitted.
Datatype TS.png
DCM::DefinitionCode NL-CM:2.1.6
DCM::ExampleValue 30-08-2012
data EndDate
Definition Date on which the treatment instruction ends. A ‘vague’ date, such as only the year, is permitted.

If the validity duration of the treatment instruction cannot be expressed as a date, such as “until discharge from hospital”, it can be included in the Explanation concept.

Datatype TS.png
DCM::DefinitionCode NL-CM:2.1.7
DCM::ExampleValue 31-06-2013
data Explanation
Definition Comments on the treatment instruction such as a written description of an end date which can be indicated as a date (“until discharge from hospital”).
Datatype ST.png
DCM::DefinitionCode NL-CM:2.1.15
data LivingWill::LivingWill
Definition A (written) statement in which a person indicates wishes concerning future medical action, in the event that this person is at that point no longer (deemed) capable of taking decisions on the matter.
Datatype Container.png
DCM::DefinitionCode NL-CM:2.1.14
DCM::ReferencedDefinitionCode NL-CM:7.15.1 Dit is een verwijzing naar het concept Wilsverklaring in de bouwsteen Wilsverklaring.
data VerifiedWith
Definition The person with whom the treatment instruction was discussed and verified.
Datatype CD.png
DCM::DefinitionCode NL-CM:2.1.11
DCM::ExampleValue Patient
DCM::ValueSet File:List.png VerifiedWithCodeList OID: 2.16.840.1.113883.
data Treatment
Definition The medical treatment to which the treatment instruction applies.
Datatype CD.png
DCM::DefinitionCode NL-CM:2.1.3
DCM::DefinitionCode SNOMED CT: 50731006 Medical procedure (procedure)
DCM::ExampleValue Opname op intensive care
DCM::ValueSet File:List.png TreatmentCodeList OID: 2.16.840.1.113883.
data TreatmentPermitted
Definition Indication of permission for the treatment, no permission for the treatment, or permission for the treatment with constraints.
Datatype CD.png
DCM::DefinitionCode NL-CM:2.1.4
DCM::ExampleValue Ja,maar met beprekingen
DCM::ValueSet File:List.png TreatmentPermittedCodeList OID: 2.16.840.1.113883.

Code Lists



Concept Name Concept Code Coding Syst. Name Coding System OID Description
Admission to intensive care unit (procedure) 305351004 SNOMED CT 2.16.840.1.113883.6.96 Opname op intensive care
Cardiopulmonary resuscitation (procedure) 89666000 SNOMED CT 2.16.840.1.113883.6.96 Cardiopulmonaire resuscitatie
Artificial respiration (procedure) 40617009 SNOMED CT 2.16.840.1.113883.6.96 Kunstmatige beademing
Administration of blood product (procedure) 116762002 SNOMED CT 2.16.840.1.113883.6.96 Toediening van een bloedproduct
Other OTH NullFlavor 2.16.840.1.113883.5.1008 Overige behandelingen, namelijk (in vrije tekst meegeven)



Concept Name Concept Code Coding Syst. Name Coding System OID Description
Ja JA NL-CM-CS 2.16.840.1.113883. Behandeling is toegestaan en/of wenselijk.
Ja, maar met beperkingen JA_MAAR NL-CM-CS 2.16.840.1.113883. Behandeling toegestaan en/of wenselijk maar met beperkingen die dan ook vermeld moeten worden
Nee NEE NL-CM-CS 2.16.840.1.113883. Behandeling niet toegestaan en/of wenselijk



Concept Name Concept Code Coding Syst. Name Coding System OID Description
Patient 116154003 SNOMED CT 2.16.840.1.113883.6.96 Pati\'ebnt
Parent 40683002 SNOMED CT 2.16.840.1.113883.6.96 Ouder
Guardian 394619001 SNOMED CT 2.16.840.1.113883.6.96 Voogd
Holder of enduring power of attorney 8601000146109 SNOMED CT 2.16.840.1.113883.6.96 Gevolmachtigde
Other OTH NullFlavor 2.16.840.1.113883.5.1008 Anders, namelijk (in vrije tekst meegeven)