RT FHIR CarePlan Profile

EverOncologyRTCarePlan FHIR profile for radiation therapy.

14 min read diagramsUpdated 2026-05-07docs/architecture/bia-rt-2-fhir-careplan-profile.md

Field	Value
Profile name	EverOncologyRTCarePlan
Canonical URL	`https://ever.med/fhir/StructureDefinition/oncology-rt-careplan`
Version	0.1.0
Status	draft
FHIR base	R4 (4.0.1)
Profiles base	`CarePlan`
Conforms to / aligns with	HL7 mCODE (where applicable), IHE Radiation Oncology
Companion spec	BIA-RT-1 (claim vocabulary)
Date	2026-05-07

1. Scope

EverOncologyRTCarePlan constrains FHIR CarePlan to represent a complete radiation oncology Course-of-treatment with phase/cycle decomposition, prescription detail, genomic attestation references (BIA-RT-1), tumor-conference linkage, and care-team structure sufficient for medOS oncology workflows.

It is the FHIR-side projection of the medOS internal event-sourced treatment_plan entity. The profile is exchange-format; the event log is the source of truth.

2. Why a profile and not a custom resource

Three reasons:

Interoperability. Any FHIR-aware system (mCODE-conformant US oncology platforms, Japanese partner systems via FHIR-JP, Thai HIN gateway) can read it.
Existing tooling. FHIR validators, code generators, server frameworks all work out-of-the-box.
mCODE alignment. mCODE has settled on Procedure for delivered RT (mcode-cancer-related-radiation-procedure, mcode-radiotherapy-course-summary, mcode-radiotherapy-treatment-phase). mCODE is light on the planning side, which is exactly the gap this profile fills. Together with the mCODE delivery profiles, you get end-to-end coverage.

3. Conformance

A resource asserts conformance to this profile via meta.profile:

{ "meta": { "profile": ["https://ever.med/fhir/StructureDefinition/oncology-rt-careplan"] } }

Implementations claiming Full conformance MUST satisfy all MS (Must Support) elements, all extensions marked REQUIRED, and the slicing rules in §6.

4. Differential — base CarePlan constraints

Element	Card.	Type	Constraint
`meta.profile`	1…1	canonical	MUST include this profile’s URL
`status`	1…1	code	MS — `draft \| active \| on-hold \| revoked \| completed \| entered-in-error`
`intent`	1…1	code	Fixed: `plan` for proposed, `order` once approved
`category`	1…*	CodeableConcept	MUST include `http://snomed.info/sct\|108290001` (radiotherapy procedure) AND `http://ever.med/CodeSystem/care-plan-category\|oncology-rt`
`subject`	1…1	Reference(Patient)	MS
`period`	1…1	Period	MS — start = first fraction planned, end = last fraction planned (updated as plan evolves)
`created`	1…1	dateTime	MS
`author`	1…1	Reference(Practitioner)	MS — the responsible radiation oncologist
`careTeam`	1…*	Reference(CareTeam)	MS — single CareTeam covering RO, physicist, dosimetrist, RTT, oncology nurse
`addresses`	1…*	Reference(Condition)	MS — the cancer condition(s) being treated
`supportingInfo`	0…*	Reference(*)	MS — slicing per §5
`goal`	0…*	Reference(Goal)	MS — local control, palliation, symptom relief, etc.
`activity`	1…*	BackboneElement	MS — slicing per §6 (phase decomposition)
`note`	0…*	Annotation

basedOn MUST reference the RadiationServiceRequest that initiated the plan (covers TOR 3.12.1.1).

replaces (when present) MUST reference the predecessor EverOncologyRTCarePlan for replanning continuity.

5. `supportingInfo` slicing — tumor conferences and attestations

supportingInfo is sliced (open) on resource type and tag:

Slice	Min…Max	Reference target	Purpose
`tumorConference`	0…*	`ClinicalImpression` (TumorBoard kind)	Covers TOR 3.12.1.2; M:N to plan
`genomicAttestation`	0…*	`DocumentReference` carrying BIA-RT-1 VC	Covers genomic decision basis
`priorImaging`	0…*	`ImagingStudy`	Sim CT, diagnostic imaging
`priorTherapy`	0…*	`Procedure \| MedicationStatement`	Prior RT, prior systemic

Tumor conference linkage (M:N). Each MDT discussion that touches the plan adds a supportingInfo entry. Conversely, the ClinicalImpression carries subject (patient) and an extension tumor-conference-plans-reviewed listing all plan IDs reviewed in that conference. This bidirectional linkage is the canonical M:N representation in FHIR.

"supportingInfo": [
  {
    "reference": "ClinicalImpression/mdt-2026-03-15-case-12",
    "type": "ClinicalImpression",
    "display": "Head & Neck MDT 2026-03-15"
  },
  {
    "reference": "DocumentReference/genomic-vc-abc123",
    "type": "DocumentReference",
    "display": "BIA-RT genomic attestation (HPV+, ATM het, DPYD wt)"
  }
]

6. `activity` slicing — phases / cycles

The core structural commitment of the profile.

activity is sliced (open) on extension[phase-number].valueInteger.

Each activity slice represents one Phase of the course (initial, boost, SIB, brachy insertion, re-irradiation, etc.). Slicing rules:

Min cardinality 1, max unbounded.
Slices ordered by phase number.
Each slice MUST carry the oncology-rt-phase extension (§7.1) on activity.detail.
Each slice’s activity.detail.kind SHALL be ServiceRequest.
Each slice’s activity.detail.code SHALL carry a procedure code from the radiation procedure value set (§9).
Each slice’s activity.detail.scheduledTiming SHALL describe the fractionation pattern.

"activity": [
  {
    "extension": [
      {
        "url": "https://ever.med/fhir/StructureDefinition/oncology-rt-phase",
        "extension": [
          { "url": "phaseNumber", "valueInteger": 1 },
          { "url": "phaseName", "valueString": "Initial" },
          { "url": "intent", "valueCode": "definitive" }
        ]
      }
    ],
    "detail": {
      "kind": "ServiceRequest",
      "code": { "coding": [{ "system": "http://snomed.info/sct", "code": "1287742003", "display": "IMRT" }] },
      "status": "in-progress",
      "scheduledTiming": {
        "repeat": {
          "boundsPeriod": { "start": "2026-04-01", "end": "2026-05-09" },
          "count": 25,
          "frequency": 1,
          "period": 1, "periodUnit": "d",
          "dayOfWeek": ["mon","tue","wed","thu","fri"]
        }
      },
      "performer": [{ "reference": "CareTeam/ct-vajira-rt-1" }],
      "productCodeableConcept": {
        "extension": [
          { "url": ".../oncology-rt-prescription", "valueReference": { "reference": "Basic/rx-phase1-..." } }
        ]
      }
    }
  },
  {
    "extension": [
      {
        "url": "https://ever.med/fhir/StructureDefinition/oncology-rt-phase",
        "extension": [
          { "url": "phaseNumber", "valueInteger": 2 },
          { "url": "phaseName", "valueString": "Boost" },
          { "url": "intent", "valueCode": "definitive" }
        ]
      }
    ],
    "detail": { "...": "5 fx, 2 Gy/fx, sequential boost to GTV" }
  }
]

The “phase” terminology is intentional. In RT, phase is the unambiguous term (initial, boost, SIB). cycle is borrowed from chemotherapy and is acceptable in patient-facing language but the FHIR structure SHOULD use phase to avoid confusion across modalities. The TOR’s “Cycle” requirement (3.12.1.6) is satisfied by phase scheduling — the system MAY surface “Cycle” labels in the UI for clinician familiarity.

7. Extension definitions

7.1 `oncology-rt-phase` (complex, on `activity.detail`)

Canonical: https://ever.med/fhir/StructureDefinition/oncology-rt-phase
Type: complex extension
Context: CarePlan.activity.detail
Cardinality: 1..1 within each activity slice
Sub-extensions:
  phaseNumber  : integer (1..1)   1-based ordinal
  phaseName    : string  (1..1)   free-form: Initial | Boost | SIB | Brachy_HDR_1 | ...
  intent       : code    (1..1)   curative | palliative | adjuvant | neoadjuvant | prophylactic | salvage | reirradiation
  modality     : code    (1..1)   EBRT-3DCRT | EBRT-IMRT | EBRT-VMAT | SBRT | SRS | Brachy-LDR | Brachy-HDR | Proton | Electron | TBI
  technique    : string  (0..1)   vendor-specific technique label

7.2 `oncology-rt-prescription` (resource-shaped, referenced from `productCodeableConcept`)

Modeled as a Basic resource (or a custom Logical Model) holding the RT prescription:

Fields:
  totalDoseGy           : decimal       e.g., 50
  fractionationGy       : decimal       e.g., 2
  numberOfFractions     : integer       e.g., 25
  fractionsPerWeek      : integer       e.g., 5
  beamEnergy            : string        e.g., "6 MV", "Ir-192", "150 MeV"
  targets[]             : reference(BodyStructure)
  organsAtRisk[]        : { tissue, doseConstraint, volumeConstraint }
  approvedBy            : reference(Practitioner)   the physicist co-sign
  approvedDate          : dateTime
  protocolReference     : reference(PlanDefinition) | uri      RTOG/EORTC/local

A Basic carrier is acceptable for v0.1; v0.2 should evaluate moving to a PlanDefinition + ActivityDefinition pattern or a custom Logical Model published as an IG.

7.3 `oncology-rt-genomic-attestation` (complex, on `CarePlan`)

Canonical: https://ever.med/fhir/StructureDefinition/oncology-rt-genomic-attestation
Type: complex extension
Context: CarePlan (i.e., on the resource itself)
Cardinality: 0..1
Sub-extensions:
  identityBinding       : reference(DocumentReference)  (1..1)  REQUIRED — BIA-RT C-16
  germlineRisk          : reference(DocumentReference)  (0..*)  C-01, C-02, C-03
  tumorMarkers          : reference(DocumentReference)  (0..*)  C-04..C-08
  radiosensitivityModel : reference(DocumentReference)  (0..*)  C-09, C-10
  pharmacogenomics      : reference(DocumentReference)  (0..*)  C-11, C-12
  lateEffectRisk        : reference(DocumentReference)  (0..*)  C-13, C-14
  provenance            : reference(DocumentReference)  (1..*)  C-15
Constraint: bia-rt-binding
  Where any of {germlineRisk, tumorMarkers, radiosensitivityModel,
  pharmacogenomics, lateEffectRisk} is present, identityBinding MUST be present
  and MUST verify against all referenced credentials.

The referenced DocumentReference resources carry the BIA-RT-1 VC payloads as attachment.data (base64-encoded JSON-LD) or attachment.url pointing to the wallet-resolvable VC.

7.4 `oncology-rt-replan-of` (simple, on `CarePlan`)

Canonical: https://ever.med/fhir/StructureDefinition/oncology-rt-replan-of
Type: Reference(CarePlan)
Cardinality: 0..1
Context: CarePlan
Use: when an active plan is closed and a replan is opened mid-course
(setup change, anatomical change, toxicity-driven dose modification),
the new plan references the predecessor.
Distinct from CarePlan.replaces: replan-of is a soft link preserving
both plans as separate active artifacts during transition.

7.5 `oncology-rt-clinical-intent` (simple, on `CarePlan`)

Canonical: https://ever.med/fhir/StructureDefinition/oncology-rt-clinical-intent
Type: code
Cardinality: 1..1
Context: CarePlan
ValueSet: curative | palliative | adjuvant | neoadjuvant | prophylactic | salvage

This sits at the plan level (overall intent). Phase-level intent (§7.1) MAY differ for individual phases.

8. Required references — the linked resources

A complete EverOncologyRTCarePlan instance points to (or is pointed to by) the following:

Resource	Direction	Profile	Purpose
`Patient`	CarePlan →	(any)	Subject
`Condition`	CarePlan →	mCODE Primary Cancer Condition	Diagnosis
`ServiceRequest`	CarePlan → (`basedOn`)	`EverRadiationServiceRequest`	The order — TOR 3.12.1.1
`ClinicalImpression`	CarePlan → (`supportingInfo`)	`EverTumorBoardNote`	TOR 3.12.1.2
`CareTeam`	CarePlan →	—	The RT team
`Goal`	CarePlan →	—	Clinical goals
`Appointment`	→ CarePlan (`basedOn`)	`EverRTFractionAppointment`	TOR 3.12.1.6
`Procedure`	→ CarePlan (`basedOn`)	mCODE Cancer-Related Radiation Procedure	Each delivered fraction
`Observation`	→ CarePlan (`derivedFrom`)	mCODE Tumor Marker Test, etc.	Toxicity (CTCAE), QoL, dosimetry observations
`DocumentReference`	CarePlan → (extension)	—	BIA-RT VC payloads

9. Code systems & value sets

The profile relies on:

Procedures: SNOMED CT (1287742003 IMRT, 152181000119107 VMAT, etc.) plus a local CodeSystem http://ever.med/CodeSystem/rt-procedure for techniques not yet in SNOMED.
Modality: http://ever.med/CodeSystem/rt-modality — covers EBRT-3DCRT, EBRT-IMRT, EBRT-VMAT, SBRT, SRS, Brachy-LDR, Brachy-HDR, Proton, Electron, TBI.
Intent: http://ever.med/CodeSystem/rt-intent — curative, palliative, adjuvant, neoadjuvant, prophylactic, salvage, reirradiation.
Body sites: ICD-O-3 topography codes for tumor location, BodyStructure references for target volumes (CTV, PTV, GTV), AAPM TG-263 nomenclature for organ-at-risk naming (covers TOR 3.12.1.4 — radiation coding).
Toxicity: NCI CTCAE v5.0 via http://terminology.hl7.org/CodeSystem/ctcae.
Billing codes: ICD-9-CM Vol 3 / TMLT for Thai context, CPT for US, K-codes for Japan — carried on the Procedure resources for delivered fractions, not on the plan.

10. Mapping to TOR requirements (3.12.1.x)

TOR	Spec satisfaction
3.12.1.1 สั่งรายการการตรวจรักษาด้วยรังสี	`EverRadiationServiceRequest` referenced from `CarePlan.basedOn`; the request initiates the plan
3.12.1.2 Tumor Conference notes	`ClinicalImpression` (kind: TumorBoard) referenced via `supportingInfo[tumorConference]`; M:N supported via bidirectional reference
3.12.1.3 Continuous history (cycle / same plan)	Single `CarePlan.id` carries `treatment_plan_id` semantics; all child Appointments and Procedures `basedOn` the plan; history view = `_revinclude` on Plan id
3.12.1.4 Radiation coding	Procedure codes on `activity.detail.code`; AAPM TG-263 OAR naming; CTCAE for toxicity; billing codes on delivered `Procedure` resources
3.12.1.6 Cycle-based appointment	`activity[].detail.scheduledTiming.repeat` declares the pattern; appointment generator service produces `Appointment` resources with `basedOn` → CarePlan and a custom `phase` extension

3.12.1.5 is reserved (likely a TOR numbering gap) — confirm with Vajira documentation.

11. Example instance (abbreviated)

{
  "resourceType": "CarePlan",
  "id": "rt-plan-h-and-n-2026-04-001",
  "meta": {
    "profile": ["https://ever.med/fhir/StructureDefinition/oncology-rt-careplan"]
  },
  "extension": [
    {
      "url": "https://ever.med/fhir/StructureDefinition/oncology-rt-clinical-intent",
      "valueCode": "curative"
    },
    {
      "url": "https://ever.med/fhir/StructureDefinition/oncology-rt-genomic-attestation",
      "extension": [
        { "url": "identityBinding",
          "valueReference": { "reference": "DocumentReference/vc-bind-001" } },
        { "url": "tumorMarkers",
          "valueReference": { "reference": "DocumentReference/vc-hpv-001" } },
        { "url": "germlineRisk",
          "valueReference": { "reference": "DocumentReference/vc-atm-001" } },
        { "url": "pharmacogenomics",
          "valueReference": { "reference": "DocumentReference/vc-dpyd-001" } },
        { "url": "provenance",
          "valueReference": { "reference": "DocumentReference/vc-provenance-001" } }
      ]
    }
  ],
  "status": "active",
  "intent": "order",
  "category": [
    { "coding": [
      { "system": "http://snomed.info/sct", "code": "108290001", "display": "Radiotherapy procedure" },
      { "system": "http://ever.med/CodeSystem/care-plan-category", "code": "oncology-rt" }
    ]}
  ],
  "subject": { "reference": "Patient/p-12345678", "display": "P. R., F 54" },
  "period": { "start": "2026-04-01", "end": "2026-05-16" },
  "created": "2026-03-28T14:22:00+07:00",
  "author": { "reference": "Practitioner/dr-radonc-vajira-01" },
  "careTeam": [{ "reference": "CareTeam/ct-vajira-rt-1" }],
  "addresses": [{ "reference": "Condition/c-oropharyngeal-scc-001" }],
  "basedOn": [{ "reference": "ServiceRequest/sr-rt-001" }],
  "supportingInfo": [
    { "reference": "ClinicalImpression/mdt-2026-03-15-case-12",
      "display": "Head & Neck MDT 2026-03-15" }
  ],
  "goal": [{ "reference": "Goal/g-local-control" }],
  "activity": [
    {
      "extension": [{
        "url": "https://ever.med/fhir/StructureDefinition/oncology-rt-phase",
        "extension": [
          { "url": "phaseNumber", "valueInteger": 1 },
          { "url": "phaseName", "valueString": "Initial" },
          { "url": "intent", "valueCode": "curative" },
          { "url": "modality", "valueCode": "EBRT-IMRT" },
          { "url": "technique", "valueString": "VMAT 2-arc" }
        ]
      }],
      "detail": {
        "kind": "ServiceRequest",
        "code": { "coding": [
          { "system": "http://snomed.info/sct", "code": "1287742003", "display": "IMRT" }
        ]},
        "status": "in-progress",
        "scheduledTiming": {
          "repeat": {
            "boundsPeriod": { "start": "2026-04-01", "end": "2026-05-09" },
            "count": 25, "frequency": 1, "period": 1, "periodUnit": "d",
            "dayOfWeek": ["mon","tue","wed","thu","fri"]
          }
        },
        "performer": [{ "reference": "CareTeam/ct-vajira-rt-1" }],
        "productCodeableConcept": {
          "extension": [{
            "url": "https://ever.med/fhir/StructureDefinition/oncology-rt-prescription",
            "valueReference": { "reference": "Basic/rx-phase1-001" }
          }]
        }
      }
    },
    {
      "extension": [{
        "url": "https://ever.med/fhir/StructureDefinition/oncology-rt-phase",
        "extension": [
          { "url": "phaseNumber", "valueInteger": 2 },
          { "url": "phaseName", "valueString": "Boost" },
          { "url": "intent", "valueCode": "curative" },
          { "url": "modality", "valueCode": "EBRT-IMRT" }
        ]
      }],
      "detail": {
        "kind": "ServiceRequest",
        "code": { "coding": [{ "system": "http://snomed.info/sct", "code": "1287742003" }]},
        "status": "scheduled",
        "scheduledTiming": {
          "repeat": {
            "boundsPeriod": { "start": "2026-05-10", "end": "2026-05-16" },
            "count": 5, "frequency": 1, "period": 1, "periodUnit": "d",
            "dayOfWeek": ["mon","tue","wed","thu","fri"]
          }
        }
      }
    }
  ]
}

12. Operations & query patterns

Get the continuous history of a plan (TOR 3.12.1.3):

GET [base]/CarePlan/{id}?_revinclude=Procedure:based-on
                       &_revinclude=Appointment:based-on
                       &_revinclude=Observation:derived-from
                       &_include=CarePlan:supporting-info
                       &_include=CarePlan:based-on

Returns plan + all delivered fractions + all appointments + all toxicity observations + tumor conference notes + the originating service request, in a single Bundle. The medOS UI renders this as the Treatment Lane and event feed of the Plan Cockpit.

Bulk-create appointments for a phase (TOR 3.12.1.6):

POST [base]/$rt-generate-appointments
{
  "carePlanId": "rt-plan-...",
  "phaseNumber": 1
}

Custom operation that reads the phase’s scheduledTiming and produces N Appointment resources, each with basedOn → CarePlan and extension[fractionNumber]. Idempotent on (carePlanId, phaseNumber).

Diff between plan versions (replan workflow):

GET [base]/CarePlan/{id}/_history/{vid1}
GET [base]/CarePlan/{id}/_history/{vid2}

medOS computes a JSON-Patch-shaped diff between phase prescriptions and renders the change set in the Plan Cockpit.

Patient view of own plans (Ever HealthWallet):

GET [base]/CarePlan?subject=Patient/{id}
                   &category=oncology-rt
                   &_sort=-period
                   &_summary=true

Lightweight summary the patient companion app reads.

13. mCODE alignment

This profile composes cleanly with mCODE:

mCODE Primary Cancer Condition — referenced from addresses. No conflict.
mCODE Cancer Stage Group — Observation, referenced by Condition. No conflict.
mCODE Cancer-Related Radiation Procedure — represents delivered fractions; references this CarePlan via basedOn.
mCODE Radiotherapy Course Summary — produced at end of treatment as a summary Procedure, references this plan via partOf.
mCODE Radiotherapy Treatment Phase — produced per phase at phase completion, references this plan and its specific phase activity.

The relationship: EverOncologyRTCarePlan is the prospective planning artifact; mCODE Course Summary / Treatment Phase are the retrospective delivery artifacts. Both are valuable; both should exist.

14. Implementation notes for medOS

Source of truth. The medOS internal treatment_plan event log is authoritative. The FHIR CarePlan is a projection produced by a serializer that folds events into the resource shape above. meta.versionId and meta.lastUpdated reflect the latest event.
Event types that mutate the plan. PlanCreated, PhaseAdded, PrescriptionApproved, PlanLocked, AppointmentsGenerated, PlanAmended, PhaseCompleted, PlanClosed, TumorConferenceLinked, GenomicAttestationAttached. Each event is reified as a Provenance resource pointing to the resulting CarePlan version.
Air-gapped operation (Vajira context). The plan and all referenced VCs MUST be fully resolvable within the air-gapped network. BIA-RT credentials are mirrored locally; revocation lists are pulled on a scheduled basis with TTL-expiry semantics so a network partition does not block clinical operations beyond the cache window.
AI Safety Gate. Any AI-generated suggestion that would mutate the plan (auto-prescription, auto-replan trigger, auto-toxicity grade) MUST pass through the AI Safety Gate. The gate’s pass/fail decision is itself recorded as a Provenance resource on the resulting plan version, with the suggestion content and the gate’s reasoning. This is the audit trail that makes AI-assisted RT planning insurable and regulatable.
Multi-country localization. Code system bindings are layered: the profile binds types of codes (procedure, intent, modality), and a country pack supplies the country-specific values (TMLT for Thailand, ICD-9-CM Vol 3 for Japan, CPT for US). The profile remains stable; country packs swap.
Patient-facing projection. Ever HealthWallet renders a stripped-down view of the CarePlan: phases as journey stops, period as timeline, status as plain language, dose-to-date as a fuel gauge. This view is a separate render of the same CarePlan resource — no parallel data structure.

15. Open questions for v0.2

Brachytherapy modeling. Each insertion is closer to a Procedure than a phase. Should brachy use a different activity shape (one activity per insertion) or stay in the phase model? Probably the former — brachy gets its own activity slice variant.
Adaptive RT. Daily plan modification (online adaptive workflow on Ethos / MR-linac). Is each adaptive plan a new EverOncologyRTCarePlan version or a daily Procedure-level deviation note? Initial leaning: daily deviation note up to a threshold; full replan beyond it.
PlanDefinition. Should institutional protocols (RTOG-1016, EORTC-XX, local Vajira H&N protocol) be encoded as PlanDefinition resources that instantiate EverOncologyRTCarePlan? Yes, in v0.2 — this gives protocol governance a first-class home.
Outcome reporting. PROMs, QoL, late-toxicity follow-up — all Observation, all derivedFrom the CarePlan. Need a follow-up schedule slice on activity for the survivorship phase? Probably yes.
Compatibility with IHE Radiation Oncology. Map onto IHE-RO TDW-II (Treatment Delivery Workflow) for the actual delivery side; this profile sits one layer above.

16. Files to ship in the IG

For a publishable Implementation Guide:

fsh/
  StructureDefinition-EverOncologyRTCarePlan.fsh
  StructureDefinition-EverRadiationServiceRequest.fsh
  StructureDefinition-EverTumorBoardNote.fsh
  StructureDefinition-EverRTFractionAppointment.fsh
  StructureDefinition-Extension-oncology-rt-phase.fsh
  StructureDefinition-Extension-oncology-rt-prescription.fsh
  StructureDefinition-Extension-oncology-rt-genomic-attestation.fsh
  StructureDefinition-Extension-oncology-rt-replan-of.fsh
  StructureDefinition-Extension-oncology-rt-clinical-intent.fsh
  CodeSystem-rt-modality.fsh
  CodeSystem-rt-intent.fsh
  CodeSystem-rt-procedure.fsh
  ValueSet-rt-modality.fsh
  ValueSet-rt-intent.fsh
  ValueSet-rt-procedure.fsh
  examples/
    careplan-h-and-n-curative.json
    careplan-palliative-bone-mets.json
    careplan-replan-mid-course.json

FSH (FHIR Shorthand) authoring is the path of least resistance; SUSHI compiles to the IG. Estimated effort: ~2 weeks for first publishable IG given the differential above.

End of BIA-RT-2 v0.1