German Practice Management FHIR Profiles (R4)
0.71.0 - STU1
DE
German Practice Management FHIR Profiles (R4) - Local Development build (v0.71.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
This page documents the architectural decisions (ADRs) that shape the design of this Implementation Guide.
| Status: Accepted | Date: 2026-05-18 |
Summary: The IG treats KBV AW-SST/PVS-AWS as a semantic crosswalk target for
archive and system-change export, not as a profile parent layer. Local profiles
must not derive from KBV_PR_AW_*, and kbv.ita.aws remains outside direct
package dependencies. The main implementation follow-up is an AW-aligned local
Claim profile set while preserving the local ChargeItem/Claim/Invoice
separation.
Full ADR: ADR-003-aw-sst-crosswalk.md
Crosswalk: AW-SST Crosswalk
| Decision | Rationale |
|---|---|
| No AW parent inheritance | AW-SST is archive/export-shaped and would remove needed live-workflow semantics |
No direct kbv.ita.aws dependency |
The published package stack is older than this IG stack and is not needed for local validation |
| AW as crosswalk target | AW-SST remains the official semantic reference for PVS archive/change export |
| Claim implementation required | AW's preliminary/final Claim split is useful and should be reflected in local billing Claim profiles |
| Scope kept narrow | Follow-up is tracked as one AW bead, not a broad profile-harmonization program |
| Status: Accepted | Date: 2026-04-27 |
Summary: The IG separates Plan-Library resources (PlanDefinition, ActivityDefinition, CarePlan —
emitted by PVS adapters into FHIR servers) from downstream Rule-Execution services. Computability
slots (condition, applicability, dynamicValue) are intentionally not populated in plan-library
resources. Plan variants are differentiated via the praxis-plan-topic CodeSystem, not separate profiles.
Full ADR: ADR-001-plan-library-vs-rule-execution.md
| Decision | Rationale |
|---|---|
| Plan-Library in FHIR | Declarative, forward-directed templates belong in FHIR with mature profile support |
| Rule-Execution outside the IG | Billing validation rules are not necessarily CQL-shaped; operational stores can meet performance targets |
| No CPG adoption | EBM/BEMA/HZV rules are quartalsbezogen and Kassen-specific — not mappable to CQL phenotypes |
Single PraxisBillingPattern profile |
Job/Chain/DMP/HZV variants differ only in section composition — topic CodeSystem is sufficient |
No hkp-status extension |
Da Vinci PAS dual-lifecycle (CarePlan + Claim/ClaimResponse) is already present since v0.40.0 |
praxis-plan-topic and praxis-plan-section CodeSystems; empty computability slots are by designPraxisBillingPattern remains the single PlanDefinition emission target; topic from praxis-plan-topic