feat: Adding FMK Medication to DK Core

input/fsh/DkCoreCondition.fsh

@@ -42,6 +42,27 @@ Description: "HL7 Denmark core profile for professionally asserted conditions, a
 * recorder only Reference(DkCorePractitioner or DkCorePractitionerRole or DkCorePatient or DkCoreRelatedPerson)
 * asserter only Reference(DkCorePractitioner or DkCorePractitionerRole)
 
+Mapping: DkCoreConditionToDanishClassifications
+Source: DkCoreCondition
+Target: "https://medinfo.dk/sks/brows.php"
+Title: "Danish Condition Classifications (SKS-D, ICPC-2, FSIII, FFB)"
+Id: dk-core-condition-classifications
+* -> "Condition / Tilstand" "**Danish condition-classification systems used across sectors. A single DkCoreCondition MAY carry multiple codings when the same condition is represented in more than one classification.**"
+* code.coding[SCTConditionCode] -> "SNOMED CT" "International SNOMED CT condition code under `http://snomed.info/sct`; bound to the FHIR R4 condition-code value set."
+* code.coding[SKS-D] -> "SKS (Sundhedsvæsenets Klassifikations System), D-hierarkiet" "Secondary-sector diagnosis code from the SKS D-hierarchy under `urn:oid:1.2.208.176.2.4.12`."
+* code.coding[ICPC2code] -> "ICPC-2" "International Classification of Primary Care, 2nd edition under `urn:oid:1.2.208.176.2.31`. Primary-care / general practice."
+* code.coding[FSIIIConditionCode] -> "FSIII tilstande" "Municipal-care condition code (Fælles Sprog III) under `urn:oid:1.2.208.176.2.21`."
+* code.coding[FFBConditionCode] -> "FFB undertemaer" "Municipal rehabilitation sub-theme code (Fælles Faglige Begreber) under `urn:oid:1.2.208.176.2.22`."
+* clinicalStatus -> "Klinisk status" "active / recurrence / relapse / inactive / remission / resolved."
+* verificationStatus -> "Verifikationsstatus" "unconfirmed / provisional / differential / confirmed / refuted / entered-in-error."
+* subject -> "Patient" "DkCorePatient reference."
+* recorder -> "Registrerer" "Who recorded the condition (Practitioner / PractitionerRole / Patient / RelatedPerson)."
+* asserter -> "Asserter" "Clinician asserting the condition (Practitioner / PractitionerRole)."
+* extension[conditionLastAssertedDate] -> "Sidst bekræftet" "Last date the condition was confirmed valid in its current state (typically last follow-up)."
+* extension[notFollowedAnymore] -> "Ikke længere fulgt" "Date the condition lost focus in a specific clinical context."
+* extension[dueTo] -> "Forårsaget af" "Link to another condition / observation that caused this condition."
+
+
 Instance: ConditionPressureUlcer
 InstanceOf: DkCoreCondition
 Title: "John tryksår"

input/fsh/DkCoreImmunization.fsh

@@ -0,0 +1,109 @@
+Profile: DkCoreImmunization
+Parent: Immunization
+Id: dk-core-immunization
+Title: "Danish Core Immunization Profile"
+Description: "HL7 Denmark core profile for an administered vaccination, aligned with Det Danske Vaccinationsregister (DDV) interface 1.4.0 + E1. A registered DDV `Vaccination` is **always** an administered/effectuated vaccination, so `status` is essentially always `completed`; `ActiveStatus` is only used to mark a deletion (a `Vaccination` may exist in several versions with `Status=A` (Active) and later be deleted, whereby the latest version gets `Status=D` (Deleted)) which maps to `entered-in-error`. Refusals/omissions are **not** recorded as DDV Vaccinations, so FHIR `status = not-done` / `statusReason` cannot be derived from DDV. Authoritative DDV XML schemas are published at https://wiki.fmk-teknik.dk/fmk:ddv:extensions:e1 with target namespace `http://vaccinationsregister.dk/schemas/2013/12/01`. A DDV `Vaccination` carries a numeric `VaccinationIdentifier` (with `VaccinationVersionIdentifier` as a revision/optimistic-locking token, mapped to `meta.versionId`), a structured `Vaccine` element (VaccineIdentifier + VaccineName + Disease[] + ATC + SSIDrug[]), an optional `Effectuated` structure (date, effectuator name, authorisation and organisation), an optional `EffectuatedPlannedItem` (course/series context), `CoverageDuration`, `BatchNumber`, `ActiveStatus`, `NegativeConsentIndicator` (citizen private-marking, not a refusal), `VaccinationCredibility` (credibility enum whose values include `Oprettet af borger` / citizen-created), and flags such as `IsPrevious` and `ConfirmedByPrescriptionServer`."
+* ^status = #active
+* identifier ^slicing.discriminator.type = #value
+  * ^slicing.discriminator.path = "system"
+  * ^slicing.rules = #open
+  * ^slicing.ordered = false
+  * ^slicing.description = "Slice identifier by system to carry the DDV VaccinationIdentifier"
+* identifier contains
+    DdvVaccinationId 0..1
+* identifier[DdvVaccinationId] ^short = "[DA] DDV VaccinationIdentifier - unik identifikation af en vaccination (positiv long)."
+  * system 1..
+  * system = $DdvVaccinationId (exactly)
+  * value 1..
+* meta.versionId ^short = "[DA] DDV VaccinationVersionIdentifier - revisionsnummer for vaccinationen. Bruges internt i DDV til optimistic locking ved updates og svarer til FHIRs versionsmekanisme (meta.versionId / _history)."
+* meta.security ^short = "[DA] Privatmarkering. Når DDV Vaccination.NegativeConsentIndicator = true har borgeren ønsket at privatmarkere vaccinationen. Den er stadig effektueret på lige fod med øvrige registreringer (status = completed), men må ikke synliggøres med mindre den sundhedsansvarlige anvender værdispring eller har samtykke. Markeres som dk-core gør på Patient: meta.security = http://terminology.hl7.org/CodeSystem/v3-Confidentiality#R (Restricted)."
+* status ^short = "Status for vaccinationen. En registreret DDV Vaccination er altid effektueret, så `completed` er den normale værdi (DDV Vaccination.ActiveStatus = true / Status=A). `entered-in-error` bruges når en vaccination er slettet i DDV (ActiveStatus = false / seneste version Status=D). DDV registrerer ikke afviste/undladte vaccinationer, så `not-done`/`statusReason` kan IKKE udledes af DDV. NegativeConsentIndicator er ikke en afvisning, men en privatmarkering - se meta.security."
+* statusReason ^short = "Kan IKKE udledes af DDV Vaccination-registreringer. Afviste/undladte vaccinationer registreres ikke som DDV Vaccinations, og historiske PlannedVaccinations kan ikke hentes via snitfladen."
+* vaccineCode ^short = "Vaccinen. DDV leverer strukturen DDV Vaccination.Vaccine som VaccineName (≤100 tegn fritekst), ATC (Code + Text), Disease[] (sygdom m. ATC), SSIDrug[] (SSI-lægemiddel) og DisplayMinimumVaccinationPlan[]. VaccineName mappes til vaccineCode.text; ATC til vaccineCode.coding[ATC]."
+* vaccineCode.coding ^slicing.discriminator.type = #value
+  * ^slicing.discriminator.path = "system"
+  * ^slicing.rules = #open
+  * ^slicing.ordered = false
+  * ^slicing.description = "Slice vaccineCode.coding by system to accommodate ATC or SNOMED CT coding alongside the DDV VaccineName free text"
+* vaccineCode.coding contains
+    ATC 0..1 and
+    SCTVaccineCode 0..1 and
+    DdvVaccine 0..1
+* vaccineCode.coding[ATC] ^short = "WHO ATC code for vaccinen (J07-gruppen). In DDV: Vaccination.Vaccine.ATC.Code / ATC.Text."
+  * system 1..
+  * system = $atc (exactly)
+  * code 1..
+* vaccineCode.coding[SCTVaccineCode] ^short = "SNOMED CT code for vaccinen."
+  * system 1..
+  * system = "http://snomed.info/sct"
+  * code 1..
+* vaccineCode.coding[DdvVaccine] ^short = "[DA] DDV VaccineIdentifier - SSI-numerisk identifikation af vaccinen (findes på Vaccination.Vaccine.VaccineIdentifier)."
+  * system 1..
+  * system = $DdvVaccineId (exactly)
+  * code 1..
+* patient only Reference(DkCorePatient)
+* patient 1..
+* occurrence[x] ^short = "Tidspunktet hvor vaccinationen blev givet. Mappes fra DDV Vaccination.EffectuatedDateTime (eller Vaccination.Effectuated.EffectuatedDateTime når effektueringen er leveret som struktureret element)."
+* recorded ^short = "Tidspunkt hvor vaccinationen blev registreret i DDV. Mappes fra DDV Vaccination.Created.CreatedDateTime når det findes; falder tilbage til EffectuatedDateTime."
+* performer.actor only Reference(DkCorePractitioner or DkCorePractitionerRole or DkCoreOrganization)
+* performer.actor ^short = "Den der har effektueret vaccinationen. DDV Vaccination.Effectuated.EffectuatedByName er en fritekst (≤200 tegn) og placeres i actor.display når en egentlig reference ikke er tilgængelig. Strukturerede felter: Effectuated.AuthorisationIdentifier (yder-/autorisationsnummer), Effectuated.EffectuatedByOrganisationName / Number / Type, Effectuated.EffectuatedInCountryCode."
+* lotNumber ^short = "Batchnummer. In DDV: Vaccination.BatchNumber."
+* protocolApplied.targetDisease ^short = "Sygdom(me) vaccinationen beskytter imod. In DDV: Vaccination.Vaccine.Disease[] (DiseaseIdentifier + DiseaseName + DiseaseNameDK + ATC)."
+* protocolApplied ^short = "Vaccinationsforløb/-serie. Hvis effektueringen er sket som del af et vaccinationsforløb, findes oplysninger om forløbet typisk i DDV Vaccination.EffectuatedPlannedItem."
+* note ^short = "Fri tekst. Anvendes blandt andet til DDV CoverageDuration og felter uden et dedikeret Immunization-element. `VaccinationCredibility` angiver troværdighed/oprindelse (fx \"Oprettet af borger\" = borger-registreret). `IsPrevious = true` angiver at selve effektueringen er sket på et andet tidspunkt, sted og/eller af en anden person end den der registrerer - fx vaccinationer modtaget i udlandet eller før registrering i DDV blev lovpligtig; sådanne tidligere vaccinationer kan oprettes af både sundhedsfaglige og borgeren selv (afspejles i VaccinationCredibility). `ConfirmedByPrescriptionServer` har kun historisk interesse og siger noget om datakvaliteten - tilsvarende kan aflæses i VaccinationCredibility."
+
+
+Mapping: DkCoreImmunizationToDdv
+Source: DkCoreImmunization
+Target: "https://wiki.fmk-teknik.dk/fmk:ddv:extensions:e1"
+Title: "Det Danske Vaccinationsregister (DDV)"
+Id: dk-core-immunization-ddv
+* -> "Vaccination" "**DDV Vaccination (namespace `http://vaccinationsregister.dk/schemas/2013/12/01`).**"
+* identifier[DdvVaccinationId] -> "Vaccination.VaccinationIdentifier" "Numeric DDV identifier of the vaccination (positive long)."
+* meta.versionId -> "Vaccination.VaccinationVersionIdentifier" "Revision number, used internally in DDV for optimistic locking on updates. Maps to FHIR's resource versioning mechanism (`meta.versionId` / `_history`)."
+* status -> "Vaccination.ActiveStatus" "A registered DDV Vaccination is always effectuated, so `completed` is the normal value (ActiveStatus = true / Status=A). `entered-in-error` when the vaccination has been deleted (ActiveStatus = false / latest version Status=D). DDV does not record refusals/omissions, so `not-done`/`statusReason` cannot be derived."
+* meta.security -> "Vaccination.NegativeConsentIndicator" "`NegativeConsentIndicator = true` is a citizen private-marking (not a refusal); the vaccination is still effectuated. Carried as `meta.security = http://terminology.hl7.org/CodeSystem/v3-Confidentiality#R`, mirroring DkCorePatient. Only visible via værdispring/consent."
+* vaccineCode -> "Vaccination.Vaccine" "Structured DDV `Vaccine` (VaccineName + ATC + Disease[] + SSIDrug[] + …)."
+* vaccineCode.coding[ATC] -> "Vaccination.Vaccine.ATC.Code / ATC.Text" "WHO ATC code - typically J07*."
+* vaccineCode.coding[DdvVaccine] -> "Vaccination.Vaccine.VaccineIdentifier" "SSI numeric vaccine identifier."
+* vaccineCode.text -> "Vaccination.Vaccine.VaccineName" "Free-text product name (≤100 chars)."
+* patient -> "Patient" "Vaccinated patient (CPR reference in DDV)."
+* occurrence[x] -> "Vaccination.EffectuatedDateTime / Vaccination.Effectuated.EffectuatedDateTime" "Time the vaccination was administered."
+* recorded -> "Vaccination.Created.CreatedDateTime" "Time the vaccination record was created in DDV."
+* performer.actor -> "Vaccination.Effectuated.EffectuatedByName / AuthorisationIdentifier / EffectuatedByOrganisationName / Number" "Who effectuated the vaccination. DDV often provides this as free text (EffectuatedByName); map to `actor.display` when no structured reference is available, or resolve `AuthorisationIdentifier` / organisation details to a DkCorePractitioner / DkCoreOrganization reference where possible."
+* lotNumber -> "Vaccination.BatchNumber" "Lot / batch number."
+* protocolApplied.targetDisease -> "Vaccination.Vaccine.Disease[]" "Target disease(s) with optional DiseaseIdentifier + DiseaseName(DK) + ATC."
+* protocolApplied -> "Vaccination.EffectuatedPlannedItem" "When the effectuation is part of a vaccination course/series, course information is usually found in the DDV `EffectuatedPlannedItem` element."
+* note -> "Vaccination.CoverageDuration / VaccinationCredibility / IsPrevious / ConfirmedByPrescriptionServer" "Free-text notes for DDV fields without a dedicated Immunization element. `IsPrevious = true` = the effectuation happened at another time/place/person than the registrar (e.g. abroad or before DDV registration was mandatory; may be created by professionals or the citizen). `ConfirmedByPrescriptionServer` has historical interest only (data quality), mirrored by `VaccinationCredibility`. `VaccinationCredibility` enum: `Slettet`, `Oprettet af læge / medhjælp`, `Oprettet på baggrund af data fra Sygesikringsregisteret`, `Udleveret på apotek og godkendt af læge`, `Oprettet af læge eller oprettet af borger og godkendt af læge`, `Udleveret på apotek`, `Oprettet af borger`."
+
+
+Instance: JohnImmunizationInfluvac
+InstanceOf: DkCoreImmunization
+Title: "John's Influvac vaccination"
+Description: "Example DkCoreImmunization derived from a DDV Vaccination record for influenza (Influvac)."
+Usage: #example
+* identifier[DdvVaccinationId].system = $DdvVaccinationId
+* identifier[DdvVaccinationId].value = "32206056656"
+* status = #completed
+* vaccineCode.text = "Influvac mod Influenza"
+* vaccineCode.coding[ATC] = $atc#J07BB02 "Influenza, inactivated, split virus or surface antigen"
+* patient = Reference(Patient/john)
+* occurrenceDateTime = "2025-09-30T09:11:14+02:00"
+* recorded = "2025-09-30T09:11:14+02:00"
+* performer.actor.display = "Danske Lægers Vaccinations Service"
+* note[+].text = "CoverageDuration: 1 year"
+* note[+].text = "VaccinationCredibility: Oprettet af læge / medhjælp"
+
+
+Instance: JohnImmunizationNegativeConsent
+InstanceOf: DkCoreImmunization
+Title: "John's privatmarkerede vaccination"
+Description: "Example DkCoreImmunization for a DDV Vaccination where NegativeConsentIndicator = true. The vaccination is still effectuated (status = completed); the citizen has private-marked it, so it carries a Restricted confidentiality security label and is only visible via værdispring or consent."
+Usage: #example
+* meta.security = $v3-Confidentiality#R "Restricted"
+* identifier[DdvVaccinationId].system = $DdvVaccinationId
+* identifier[DdvVaccinationId].value = "1"
+* status = #completed
+* vaccineCode.text = "Example Vaccine"
+* patient = Reference(Patient/john)
+* occurrenceDateTime = "2025-09-30"

input/fsh/DkCoreMedication.fsh

@@ -0,0 +1,65 @@
+Profile: DkCoreMedication
+Parent: Medication
+Id: dk-core-medication
+Title: "Danish Core Medication Profile"
+Description: "HL7 Denmark core profile for a medicinal product, aligned with the Danish Shared Medication Record (Fælles Medicinkort, FMK). Used where richer structured data about a drug is needed than fits in an inline CodeableConcept on MedicationRequest / MedicationStatement."
+* ^status = #active
+* code.coding ^slicing.discriminator.type = #value
+  * ^slicing.discriminator.path = "system"
+  * ^slicing.rules = #open
+  * ^slicing.ordered = false
+  * ^slicing.description = "Slice code.coding by system to accommodate the terminologies FMK uses for a drug"
+* code.coding contains
+    ATC 0..1 and
+    ActiveSubstance 0..1 and
+    Varenummer 0..1
+* code.coding[ATC]
+  * ^short = "WHO ATC code. In FMK: DrugMedication.Drug.ATC (Code + Text)."
+  * system 1..
+  * system = $atc (exactly)
+  * code 1..
+* code.coding[ActiveSubstance]
+  * ^short = "[DA] Aktivt stof. In FMK: DrugMedication.Drug.Substances.ActiveSubstance."
+  * system 1..
+  * system = $FmkActiveSubstance (exactly)
+  * code 1..
+* code.coding[Varenummer]
+  * ^short = "[DA] Varenummer fra Medicinpriser (LMS01 felt 1, 11-cifret). In FMK: DrugMedication.Drug.Identifier (source = Medicinpriser / Local / Magistrel / Stærke vitaminer m.v. / Tilknyttede behandlinger)."
+  * system 1..
+  * system = $FmkDrugId (exactly)
+  * code 1..
+* form ^short = "[DA] Lægemiddelform. In FMK: DrugMedication.Drug.Form (Code + Text)."
+* ingredient.strength ^short = "[DA] Styrke. In FMK: DrugMedication.Drug.Strength (Value + UnitCode + UnitText, or free text)."
+* manufacturer only Reference(DkCoreOrganization)
+
+
+Mapping: DkCoreMedicationToFmk
+Source: DkCoreMedication
+Target: "https://wiki.fmk-teknik.dk/fmk:extensions:e5"
+Title: "Fælles Medicinkort (FMK)"
+Id: dk-core-medication-fmk
+* -> "DrugMedication.Drug" "**Named medicinal product within an FMK DrugMedication (lægemiddelordination).**"
+* code.coding[ATC] -> "DrugMedication.Drug.ATC.Code / ATC.Text" "WHO ATC code."
+* code.coding[ActiveSubstance] -> "DrugMedication.Drug.Substances.ActiveSubstance" "Active-substance coding (source: Medicinpriser / Local / Magistrel)."
+* code.coding[Varenummer] -> "DrugMedication.Drug.Identifier" "Danish drug product number (varenummer, 11-digit, Medicinpriser)."
+* code.text -> "DrugMedication.Drug.Name (+ Form/Strength)" "Free-text rendering of the drug name, form and strength."
+* form -> "DrugMedication.Drug.Form" "Lægemiddelform (Code + Text)."
+* ingredient.strength -> "DrugMedication.Drug.Strength" "Styrke (Value + UnitCode + UnitText, or free text)."
+* manufacturer -> "DrugMedication.Drug (manufacturer)" "Organisation reference for the drug manufacturer."
+
+
+Instance: SimvastatinActavis40mg
+InstanceOf: DkCoreMedication
+Title: "Simvastatin \"Actavis\" 40 mg filmovertrukne tabletter"
+Description: "Example DkCoreMedication for a named Simvastatin product, as it might be drawn from FMK's DrugMedication."
+Usage: #example
+* code.coding[ATC] = $atc#C10AA01 "Simvastatin"
+* code.coding[ActiveSubstance].system = $FmkActiveSubstance
+* code.coding[ActiveSubstance].code = #simvastatin
+* code.coding[ActiveSubstance].display = "Simvastatin"
+* code.text = "Simvastatin \"Actavis\" filmovertrukne tabletter 40 mg"
+* status = #active
+* form.text = "filmovertrukne tabletter"
+* ingredient.itemCodeableConcept.coding = $FmkActiveSubstance#simvastatin "Simvastatin"
+* ingredient.strength.numerator = 40 'mg' "mg"
+* ingredient.strength.denominator = 1 '{tablet}' "tablet"