Advance Care Planning (PZP)
1.0.0 - release

This page is part of the Advance Care Planning (PZP) (v1.0.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Change Log

1.0.0

Issue Short Description
#171 Renamed ACP Legally Capable profile to ACP Legally Capable Regarding Medical Treatment Decisions to better reflect the content of the information.
#163 Added an Anders, namelijk item to the to the Preferred Place of Death questionnaire item, enabling users to provide additional details when none of the predefined answer options are applicable.
#172 Corrected outdated ValueSet references in the ACP questionnaire following ValueSet canonical URL changes.
#144 Refined conformance requirements by adding Must Support to all elements with obligations and removed the obligation and reference from the ACP Request to Inform Relatives recipient element.
#175 Provided guidance on how to distuingish ICD deactivation from other additional 'Other' treatment directive on data exchange page.
#176 Expanded the data exchange documentation with a code-to-profile mapping table, explicitly linking SNOMED CT observation codes used in search queries to their corresponding ACP Observation profiles.
#164 Corrected an inconsistency in the CommunicationRequest search query by using the typed patient reference (Patient/[id]).
#170 Improved the DeviceUseStatement search query example to use typed reference chaining (device:Device.type).
#165 Removed the obsolete reference to .extension:legallyCapableMedicalTreatmentDecisions from the ACP Patient - Changes compared to nl-core section.
#158 Added How to Read this Guide section to homepage.

1.0.0-rc3

Issue Short Description
#137 Replaced legally capable extension on Patient with an Observation to better support representation of legal capacity.
#132 Updated Procedure.code to support multiple ACP procedure codes and ensure compliance with zib/nl-core terminology requirements.
#157 Updated CommunicationRequest cardinalities by requiring subject, requester and sender, and adding an invariant to ensure either authoredOn or a reference to Encounter.
#151 Corrected search URLs by fixing code parameter syntax to ensure proper OR behavior.
#136 Improved search query documentation by clarifying how to retrieve specific data items such as ContactPerson (e.g. legal representative).
#135 Updated questionnaire answer options to use answerValueSet references where possible and improve alignment with terminology, resolving validation issues.
#138 Updated a couple questionnaire items from choice to boolean to resolve validation issues and align with the dataset.
#126 Updated questionnaire to align with latest dataset changes, including support for 'other' treatment directives and addition of missing 'MeetMethode' elements.
#131 Replaced fixed questionnaire answer options for 'Functie (specialisme)' with AGB and UZI value sets.
#138 Updated yes/no questions in the questionnaire to use boolean instead of choice.
#133 Aligned API documentation by correcting CommunicationRequest category code in sequence diagram and updating CapabilityStatement to use CommunicationRequest.
#129 Clarified ContactPerson artifact documentation for .relationship:roleAdditional slice.
#127 Added missing subject references to QuestionnaireResponse examples and improved consistency of author/source formatting.
#156 Applied QA fixes including ValueSet renaming to avoid duplicate titles.

1.0.0-rc2

Issue Short Description
#90 Refined the Medical Policy Goal profile by adding an ACP-specific SNOMED category, updating search parameters to use category-based retrieval and including the ‘unknown’ option to the valueset.
#83 Aligned the ACP‑OtherImportantInformation profile metadata with the intended SNOMED concept by renaming the profile to ACPSenseOfPurpose, updating identity elements for consistency.
#84 Corrected invalid _include: syntax in multiple search URLs and aligned all queries by standardizing the use of subject=Patient/[id] notation.
#92 Added an ACP prefix to all StructureDefinition.title elements.
#81 Added Observation.method.code to clarify that the organ‑donation finding is patient‑reported and improved description.
#93 Expanded and refined the obligations guidance in the IG by adding the missing obligation flag for Consent.provision.code in the TreatmentDirective, and clarifying the overall obligation design principles and mapping approach.
#55 Added a brief routing statement to the General API Requirements to clarify message/endpoint routing expectations.
#95 Added the missing role field for the first contact person in the FHIR questionnaire and updated the birthdate datatype from dateTime to date.
#64 Removed unnecessary constraints on Procedure.performer.actor in the ACP Procedure profile.
#70 Addedd data‑exchange sequence diagrams.
#71 Removed the EncounterReference extension
#101 Added a reference to IHE‑ITI‑119 as an example mechanism for obtaining the Patient ID.
#43 Prettified and standardized the search queries.
#50 Fixed incorrect handling of obligation extensions.
#54 Removed the outdated Beta3 28‑08‑2025 from the questionnaire title.
#56 Reorganized the R4 and STU3 example sets for consistency and aligned naming across all examples.
#59 Improved rendering of advance directive extension in the IG.
#62 Improved how impactful differences from base profiles are shown in the IG.
#63 Redesigned Communication profile into CommunicationRequest profile.
#73 Corrected typo in comment provision.code.text.
#82 Added an obligation flag for Observation.performer.
#99 Made all ICD SNOMED codes explicit in the ValueSet ACP-MedicalDeviceProductType-ICD and search URLs to reduce implementation burden.
#107 Added the missing contact‑person role code 310141000146103 for "schriftelijk gemachtigde" and relaxed the cardinality constraints.
#113 Removed incorrect uses of Questionnaire.item.code and cleaned up all item code fields.
#91 Updated the IG text and homepage to clearly separate the STU3/zib2017 and R4/zib2020 versions.

1.0.0-rc1

Issue Short Description
#44 Updated the Goal search query to directly use SNOMED codes instead of referencing the ACP-MedicalPolicyGoal value set, following HL7 validation feedback.
#40 Added obligation extensions and updated IG documentation to clearly indicate which elements are relevant for the ACP/PZP use case.
#37 Updated the canonical URLs in the Implementation Guide to align with the hosting location and prepare for release.
#31 Separated STU3-related examples and utilities into a dedicated repository to comply with HL7 IG tooling requirements.
#30 Updated textual references to reflect new naming conventions for PZP/ACP datasets and forms; package name remains unchanged.
#29 Replaced the SNOMED OID with the correct URI (http://snomed.info/sct) in the Device value set.
#28 Updated Questionnaire items to use the prefix element for numbering (e.g., "1.", "a)"), improving structure and FHIR compliance.
#26 Replaced "ja" and "nee" with "wel uitvoeren" and "niet uitvoeren" in the treatment directive documentation for clarity.
#25 Commented out the displayLanguage parameter to prevent automatic Dutch translations in the IG profiles.
#23 Updated ValueSet displays to consistently use Dutch terms without additional qualifiers, aligning with Nictiz conventions.
#22 Included links to the GitHub repository and issue tracker in both the STU3 and R4 Implementation Guides.
#19 History to the IG following HL7 guidelines, including setup for canonical alignment.
#18 Set up a process to publish FHIR packages on Simplifier.net, with plans for future automation via pipeline.
#14 Added automated validation for R4 IG using a CI pipeline; STU3 support is pending improvements to Firely tooling.
#9 Resolved a build error by updating resource instances and using IG Publisher v2.0.17 which handles multiple name elements.
#45 Will define server and client responsibilities for supporting exchange methods, including conformance statements and enriched ActorDefinitions.
#24 Proposed solutions for both STU3 and R4 to support an "unknown" value for the Treatment directive using custom or reused extensions; examples and test data updated accordingly.
#17 Updated terminology (e.g., "Palliatieve Zorg Planning" → "Proactieve Zorgplanning") and improved documentation text without affecting implementers.
#15 Identified and planned fixes for unresolved QA issues in STU3 examples, primarily by improving the conversion scripts from R4.