3.48.9 StructureDefinition: PrescribeIT DUR - XML Profile
XML representation of the profile-detectedissue Profile.
Narrative view of the profile
<StructureDefinition xmlns="http://hl7.org/fhir"> <id value="profile-detectedissue"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/formats.html#table" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/formats.html#table" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/formats.html#table" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a></th><th style="width: 100px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/formats.html#table" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/formats.html#table" title="Additional information about the element">Description & Constraints</a><span style="float: right"><a href="http://hl7.org/fhir/2016may/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/2016may/help16.png" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="profile-detectedissue-definitions.html#DetectedIssue" title="null">DetectedIssue</a><a name="DetectedIssue"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.4">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="profile-detectedissue-definitions.html#DetectedIssue.id" title="null">id</a><a name="DetectedIssue.id"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.4" href="http://hl7.org/fhir/2016may/datatypes.html#id">id</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: white; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="profile-detectedissue-definitions.html#DetectedIssue.patient" title="null">patient</a><a name="DetectedIssue.patient"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/references.html">Reference</a>(<a href="../common/profile-patient.html">Shared Health Patient</a>)<a href="http://hl7.org/fhir/2016may/valueset-resource-aggregation-mode.html"> {</a><a href="http://hl7.org/fhir/2016may/valueset-resource-aggregation-mode.html" title="The resource the reference points to will be found in the same bundle as the resource that includes the reference.">b</a><a href="http://hl7.org/fhir/2016may/valueset-resource-aggregation-mode.html">}</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="profile-detectedissue-definitions.html#DetectedIssue.category" title="null">category</a><a name="DetectedIssue.category"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.4">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="../common/dtprofile-codeableconcept-text.html" title="CodeableConcept">Shared Health CodeableConcept Text</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: white; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="profile-detectedissue-definitions.html#DetectedIssue.implicated" title="null">implicated</a><a name="DetectedIssue.implicated"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/references.html">Reference</a>(<a href="profile-medicationorder.html">PrescribeIT Prescription</a>)<a href="http://hl7.org/fhir/2016may/valueset-resource-aggregation-mode.html"> {</a><a href="http://hl7.org/fhir/2016may/valueset-resource-aggregation-mode.html" title="The resource the reference points to will be found in the same bundle as the resource that includes the reference.">b</a><a href="http://hl7.org/fhir/2016may/valueset-resource-aggregation-mode.html">}</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="profile-detectedissue-definitions.html#DetectedIssue.detail" title="null">detail</a><a name="DetectedIssue.detail"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.4">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.4" href="http://hl7.org/fhir/2016may/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-weight:bold">Max Length: </span><span style="color: darkgreen">1000</span></td></tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="profile-detectedissue-definitions.html#DetectedIssue.mitigation" title="null">mitigation</a><a name="DetectedIssue.mitigation"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.4">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.4" href="http://hl7.org/fhir/2016may/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck000.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="profile-detectedissue-definitions.html#DetectedIssue.mitigation.action" title="null">action</a><a name="DetectedIssue.mitigation.action"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.4">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="../common/dtprofile-codeableconcept-text-required-with-code.html" title="CodeableConcept">Shared Health CodeableConcept Required Text with optional code</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr> <tr><td colspan="5" class="hierarchy"><br/><a href="http://hl7.org/fhir/2016may/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/2016may/help16.png" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div> </text> <url value="http://prescribeit.ca/fhir/StructureDefinition/profile-detectedissue"/> <version value="2.0 Revision F"/> <name value="PrescribeIT DUR"/> <status value="draft"/> <date value="2016-03-30T17:01:25-04:00"/> <description value="Information about issues detected with a particular prescription"/> <fhirVersion value="1.4.0"/> <mapping> <identity value="v2"/> <uri value="http://hl7.org/v2"/> <name value="HL7 v2"/> </mapping> <mapping> <identity value="rim"/> <uri value="http://hl7.org/v3"/> <name value="RIM"/> </mapping> <mapping> <identity value="w5"/> <uri value="http://hl7.org/fhir/w5"/> <name value="W5 Mapping"/> </mapping> <kind value="resource"/> <abstract value="false"/> <baseType value="DetectedIssue"/> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DetectedIssue"/> <derivation value="constraint"/> <snapshot> <element id="DetectedIssue"> <path value="DetectedIssue"/> <short value="Clinical issue with action"/> <definition value="Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, Ineffective treatment frequency, Procedure-condition conflict, etc."/> <comments value="Usage Note: Detected Issue will be used to convey managed drug interactions."/> <alias value="DDI"/> <alias value="drug-drug interaction"/> <alias value="Contraindication"/> <alias value="Alert"/> <min value="0"/> <max value="*"/> <base> <path value="DetectedIssue"/> <min value="0"/> <max value="*"/> </base> <maxLength value="0"/> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="v2"/> <map value="Partial mapping from messages containing the AL1 or IAM segment, such as the ADT^A01, ADT^A08, and ADT^A60."/> </mapping> <mapping> <identity value="rim"/> <map value="Observation[classCode=ALRT, moodCode=EVN)"/> </mapping> <mapping> <identity value="w5"/> <map value="clinical.general"/> </mapping> </element> <element id="DetectedIssue.id"> <path value="DetectedIssue.id"/> <short value="Logical id of this artifact"/> <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/> <comments value="Usage Note: This will usually be a GUID and is assigned by the sending application. Ideally it should be consistent for all messages referencing this issue instance."/> <min value="1"/> <max value="1"/> <base> <path value="Resource.id"/> <min value="0"/> <max value="*"/> </base> <type> <code value="id"/> </type> <maxLength value="0"/> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> </element> <element id="DetectedIssue.meta"> <path value="DetectedIssue.meta"/> <short value="Metadata about the resource"/> <definition value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.meta"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Meta"/> </type> <maxLength value="0"/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> </element> <element id="DetectedIssue.implicitRules"> <path value="DetectedIssue.implicitRules"/> <short value="A set of rules under which this content was created"/> <definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content."/> <comments value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.implicitRules"/> <min value="0"/> <max value="*"/> </base> <type> <code value="uri"/> </type> <maxLength value="0"/> <mustSupport value="false"/> <isModifier value="true"/> <isSummary value="true"/> </element> <element id="DetectedIssue.language"> <path value="DetectedIssue.language"/> <short value="Language of the resource content"/> <definition value="The base language in which the resource is written."/> <comments value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.language"/> <min value="0"/> <max value="*"/> </base> <type> <code value="code"/> </type> <maxLength value="0"/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <strength value="required"/> <description value="A human language."/> <valueSetReference> <reference value="http://tools.ietf.org/html/bcp47"/> </valueSetReference> </binding> </element> <element id="DetectedIssue.text"> <path value="DetectedIssue.text"/> <short value="Text summary of the resource, for human interpretation"/> <definition value="A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/> <comments value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative."/> <alias value="narrative"/> <alias value="html"/> <alias value="xhtml"/> <alias value="display"/> <min value="0"/> <max value="1"/> <base> <path value="DomainResource.text"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Narrative"/> </type> <maxLength value="0"/> <condition value="dom-1"/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="Act.text?"/> </mapping> </element> <element id="DetectedIssue.contained"> <path value="DetectedIssue.contained"/> <short value="Contained, inline Resources"/> <definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope."/> <comments value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again."/> <alias value="inline resources"/> <alias value="anonymous resources"/> <alias value="contained resources"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.contained"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Resource"/> </type> <maxLength value="0"/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="DetectedIssue.extension"> <path value="DetectedIssue.extension"/> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <maxLength value="0"/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="DetectedIssue.modifierExtension"> <path value="DetectedIssue.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <maxLength value="0"/> <mustSupport value="false"/> <isModifier value="true"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="DetectedIssue.patient"> <path value="DetectedIssue.patient"/> <short value="A reference from one resource to another"/> <definition value="A reference from one resource to another."/> <requirements value="While the subject could be inferred by tracing the subject of the implicated resources, it's useful to have a direct link for query purposes."/> <min value="1"/> <max value="1"/> <base> <path value="DetectedIssue.patient"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <profile value="http://sharedhealth.exchange/fhir/StructureDefinition/profile-patient"/> <aggregation value="bundled"/> </type> <maxLength value="0"/> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)"/> </mapping> </element> <element id="DetectedIssue.category"> <path value="DetectedIssue.category"/> <short value="Concept - reference to a terminology or just text"/> <definition value="A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text."/> <comments value="This is used to express the type of interaction and is supported with a binding value set. As a data type of codeable concept, coding and text are both available, optionally to express. Conformance Rule: Drug Interactions should be populated when available. Usage Note: PMS systems who are using the same DUR database could make use of this code for linking and presentation purposes"/> <min value="0"/> <max value="1"/> <base> <path value="DetectedIssue.category"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> <profile value="http://sharedhealth.exchange/fhir/StructureDefinition/dtprofile-codeableconcept-text"/> </type> <maxLength value="0"/> <constraint> <key value="inv-1"/> <severity value="error"/> <human value="Must have coding or text but not both"/> <expression value="coding.exists() xor text.exists()"/> <xpath value="exists(f:coding)!= exists(f:text)"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <strength value="preferred"/> <description value="Codes identifying the general type of detected issue; e.g. Drug-drug interaction, Timing issue, Duplicate therapy, etc."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/detectedissue-category"/> </valueSetReference> </binding> <mapping> <identity value="orim"/> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD"/> </mapping> <mapping> <identity value="v2"/> <map value="CE/CNE/CWE"/> </mapping> <mapping> <identity value="rim"/> <map value="CD"/> </mapping> </element> <element id="DetectedIssue.severity"> <path value="DetectedIssue.severity"/> <short value="high | moderate | low"/> <definition value="Indicates the degree of importance associated with the identified issue based on the potential impact on the patient."/> <alias value="severity"/> <min value="0"/> <max value="1"/> <base> <path value="DetectedIssue.severity"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <maxLength value="0"/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <strength value="required"/> <description value="Indicates the potential degree of impact of the identified issue on the patient."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/detectedissue-severity"/> </valueSetReference> </binding> <mapping> <identity value="v2"/> <map value="AL1-4/ IAR-2"/> </mapping> <mapping> <identity value="rim"/> <map value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV].value"/> </mapping> <mapping> <identity value="w5"/> <map value="grade"/> </mapping> </element> <element id="DetectedIssue.implicated"> <path value="DetectedIssue.implicated"/> <short value="A reference from one resource to another"/> <definition value="A reference from one resource to another."/> <comments value="There's an implicit constraint on the number of implicated resources based on DetectedIssue.type; e.g. For drug-drug, there would be more than one. For timing, there would typically only be one."/> <min value="1"/> <max value="1"/> <base> <path value="DetectedIssue.implicated"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <profile value="http://prescribeit.ca/fhir/StructureDefinition/profile-medicationorder"/> <aggregation value="bundled"/> </type> <maxLength value="0"/> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)"/> </mapping> </element> <element id="DetectedIssue.detail"> <path value="DetectedIssue.detail"/> <short value="Description and context"/> <definition value="A textual explanation of the detected issue."/> <comments value="Conformance Rule: The EMR can determine which warnings should be sent, with a caution that too many warnings may not be useful. For example: Instead of sending all warnings, the Prescriber or EMR could be only the severe warnings and/or any warnings that the Prescriber specifically handled. Refer to rules in 'mitigation.action'. If an issue is provided, there is the expectation that a mitigation is also stated. Conformance Rule: Maximum character length set to ‘1000’."/> <min value="0"/> <max value="1"/> <base> <path value="DetectedIssue.detail"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <maxLength value="1000"/> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="v2"/> <map value="AL1-5 / IAM-8"/> </mapping> <mapping> <identity value="rim"/> <map value=".text"/> </mapping> </element> <element id="DetectedIssue.date"> <path value="DetectedIssue.date"/> <short value="When identified"/> <definition value="The date or date-time when the detected issue was initially identified."/> <requirements value="No-one can be responsible for mitigation prior to the issue being identified."/> <min value="0"/> <max value="1"/> <base> <path value="DetectedIssue.date"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <maxLength value="0"/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="ALI-6 / IAM-11"/> </mapping> <mapping> <identity value="rim"/> <map value=".effectiveTime"/> </mapping> <mapping> <identity value="w5"/> <map value="when.recorded"/> </mapping> </element> <element id="DetectedIssue.author"> <path value="DetectedIssue.author"/> <short value="The provider or device that identified the issue"/> <definition value="Individual or device responsible for the issue being raised. For example, a decision support application or a pharmacist conducting a medication review."/> <min value="0"/> <max value="1"/> <base> <path value="DetectedIssue.author"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> <profile value="http://hl7.org/fhir/StructureDefinition/Device"/> </type> <maxLength value="0"/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="IAM-14 / IAM-16"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode=AUT].role[classCode=ASSIGNED]"/> </mapping> <mapping> <identity value="w5"/> <map value="who.author"/> </mapping> </element> <element id="DetectedIssue.identifier"> <path value="DetectedIssue.identifier"/> <short value="Unique id for the detected issue"/> <definition value="Business identifier associated with the detected issue record."/> <requirements value="Allows linking instances of the same detected issue found on different servers."/> <min value="0"/> <max value="1"/> <base> <path value="DetectedIssue.identifier"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Identifier"/> </type> <maxLength value="0"/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="IAM-7"/> </mapping> <mapping> <identity value="rim"/> <map value=".id"/> </mapping> <mapping> <identity value="w5"/> <map value="id"/> </mapping> </element> <element id="DetectedIssue.reference"> <path value="DetectedIssue.reference"/> <short value="Authority for issue"/> <definition value="The literature, knowledge-base or similar reference that describes the propensity for the detected issue identified."/> <min value="0"/> <max value="1"/> <base> <path value="DetectedIssue.reference"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <maxLength value="0"/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=INST].target[classCode=ALRT, moodCode=DEFN].text.uri"/> </mapping> </element> <element id="DetectedIssue.mitigation"> <path value="DetectedIssue.mitigation"/> <short value="Step taken to address"/> <definition value="Indicates an action that has been taken or is committed to to reduce or eliminate the likelihood of the risk identified by the detected issue from manifesting. Can also reflect an observation of known mitigating factors that may reduce/eliminate the need for any action."/> <comments value="Mitigation is used to express the steps taken to 'mitigate' the impact of the DUR issue. If used, 'action' is mandatory, of which only the child element of 'text' must be valued. Conformance Rule: Must be provided as available. Expected to be available for each DUR code as only those that have been managed will be submitted in the message Conformance Rule: The PMS MUST display all warnings with Managed Text."/> <min value="0"/> <max value="*"/> <base> <path value="DetectedIssue.mitigation"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <maxLength value="0"/> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=MITG].target[classCode=ACT, moodCode=EVN]"/> </mapping> </element> <element id="DetectedIssue.mitigation.id"> <path value="DetectedIssue.mitigation.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references)."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="*"/> </base> <type> <code value="id"/> </type> <maxLength value="0"/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="DetectedIssue.mitigation.extension"> <path value="DetectedIssue.mitigation.extension"/> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <maxLength value="0"/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="DetectedIssue.mitigation.modifierExtension"> <path value="DetectedIssue.mitigation.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <maxLength value="0"/> <mustSupport value="false"/> <isModifier value="true"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="DetectedIssue.mitigation.action"> <path value="DetectedIssue.mitigation.action"/> <short value="Concept - reference to a terminology or just text"/> <definition value="A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text."/> <comments value="Usage Note: Text is mandatory. Coding is optional. If a code is available, it must be sent in Coding. Code + System are mandatory if coding is present."/> <min value="1"/> <max value="1"/> <base> <path value="DetectedIssue.mitigation.action"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> <profile value="http://sharedhealth.exchange/fhir/StructureDefinition/dtprofile-codeableconcept-text-required-with-code"/> </type> <maxLength value="0"/> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <strength value="preferred"/> <description value="Codes describing steps taken to resolve the issue or other circumstances that mitigate the risk associated with the issue; e.g. 'added concurrent therapy', 'prior therapy documented', etc."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/detectedissue-mitigation-action"/> </valueSetReference> </binding> <mapping> <identity value="orim"/> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD"/> </mapping> <mapping> <identity value="v2"/> <map value="CE/CNE/CWE"/> </mapping> <mapping> <identity value="rim"/> <map value="CD"/> </mapping> </element> <element id="DetectedIssue.mitigation.date"> <path value="DetectedIssue.mitigation.date"/> <short value="Date committed"/> <definition value="Indicates when the mitigating action was documented."/> <comments value="This may not be the same as when the mitigating step was actually taken."/> <min value="0"/> <max value="1"/> <base> <path value="DetectedIssue.mitigation.date"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <maxLength value="0"/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".effectiveTime"/> </mapping> </element> <element id="DetectedIssue.mitigation.author"> <path value="DetectedIssue.mitigation.author"/> <short value="Who is committing?"/> <definition value="Identifies the practitioner who determined the mitigation and takes responsibility for the mitigation step occurring."/> <min value="0"/> <max value="1"/> <base> <path value="DetectedIssue.mitigation.author"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> </type> <maxLength value="0"/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".participation[typeCode=AUT].role[classCode=ASSIGNED]"/> </mapping> </element> </snapshot> <differential> <element id="DetectedIssue"> <path value="DetectedIssue"/> <comments value="Usage Note: Detected Issue will be used to convey managed drug interactions."/> <mustSupport value="true"/> </element> <element id="DetectedIssue.id"> <path value="DetectedIssue.id"/> <comments value="Usage Note: This will usually be a GUID and is assigned by the sending application. Ideally it should be consistent for all messages referencing this issue instance."/> <min value="1"/> <mustSupport value="true"/> </element> <element id="DetectedIssue.patient"> <path value="DetectedIssue.patient"/> <min value="1"/> <type> <code value="Reference"/> <profile value="http://sharedhealth.exchange/fhir/StructureDefinition/profile-patient"/> <aggregation value="bundled"/> </type> <mustSupport value="true"/> </element> <element id="DetectedIssue.category"> <path value="DetectedIssue.category"/> <comments value="This is used to express the type of interaction and is supported with a binding value set. As a data type of codeable concept, coding and text are both available, optionally to express. Conformance Rule: Drug Interactions should be populated when available. Usage Note: PMS systems who are using the same DUR database could make use of this code for linking and presentation purposes"/> <type> <code value="CodeableConcept"/> <profile value="http://sharedhealth.exchange/fhir/StructureDefinition/dtprofile-codeableconcept-text"/> </type> <mustSupport value="true"/> </element> <element id="DetectedIssue.implicated"> <path value="DetectedIssue.implicated"/> <min value="1"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://prescribeit.ca/fhir/StructureDefinition/profile-medicationorder"/> <aggregation value="bundled"/> </type> <mustSupport value="true"/> </element> <element id="DetectedIssue.detail"> <path value="DetectedIssue.detail"/> <comments value="Conformance Rule: The EMR can determine which warnings should be sent, with a caution that too many warnings may not be useful. For example: Instead of sending all warnings, the Prescriber or EMR could be only the severe warnings and/or any warnings that the Prescriber specifically handled. Refer to rules in 'mitigation.action'. If an issue is provided, there is the expectation that a mitigation is also stated. Conformance Rule: Maximum character length set to ‘1000’."/> <maxLength value="1000"/> <mustSupport value="true"/> </element> <element id="DetectedIssue.mitigation"> <path value="DetectedIssue.mitigation"/> <comments value="Mitigation is used to express the steps taken to 'mitigate' the impact of the DUR issue. If used, 'action' is mandatory, of which only the child element of 'text' must be valued. Conformance Rule: Must be provided as available. Expected to be available for each DUR code as only those that have been managed will be submitted in the message Conformance Rule: The PMS MUST display all warnings with Managed Text."/> <mustSupport value="true"/> </element> <element id="DetectedIssue.mitigation.action"> <path value="DetectedIssue.mitigation.action"/> <min value="1"/> <type> <code value="CodeableConcept"/> <profile value="http://sharedhealth.exchange/fhir/StructureDefinition/dtprofile-codeableconcept-text-required-with-code"/> </type> <mustSupport value="true"/> </element> </differential> </StructureDefinition>