PrescribeIT® Specification and Guide Version 5.0

 

Definitions for the profile-list-allergies Profile.

1. List
Definition

A set of information summarized from a list of other resources.

Control0..*
Must Supporttrue
Alternate NamesCollection, WorkingList, Organizer
Comments

Usage Note: This is where a patient's list of allergies can be identified. For the initial implementation this will be conveyed using text only. The remaining data elements required in this segment are supplied by fixed values.

Max Length0
InvariantsDefined on this element
lst-1: A list can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty())
lst-2: The deleted flag can only be used if the mode of the list is "changes" (: mode = 'changes' or entry.deleted.empty())
2. List.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Control1..1
Typeid
Must Supporttrue
Comments

Usage Note: This will usually be a GUID and is assigned by the sending application.

Max Length0
3. List.meta
Definition

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.

Control0..1
TypeMeta
Max Length0
4. List.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

Control0..1
Typeuri
Is Modifiertrue
Comments

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.

Max Length0
5. List.language
Definition

The base language in which the resource is written.

Control0..1
BindingThe codes SHALL be taken from http://tools.ietf.org/html/bcp47 A human language.

Typecode
Comments

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).

Max Length0
6. List.text
Definition

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.

Control1..1 This element is affected by the following invariants: dom-1
TypeNarrative
Must Supporttrue
Alternate Namesnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative.

Max Length0
7. List.text.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
Max Length0
8. List.text.extension
Definition

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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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.

Max Length0
9. List.text.status
Definition

The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data.

Control1..1
BindingThe codes SHALL be taken from NarrativeStatus The status of a resource narrative

Typecode
Must Supporttrue
Comments

Fixed value: additional

Max Length0
Fixed Valueadditional
10. List.text.div
Definition

The actual narrative content, a stripped down version of XHTML.

Control1..1
Typexhtml
Must Supporttrue
Comments

Markup is prohibited - this must be a simple string providing a list of vertical-bar (|) separated allergies. For example: allergy1|allergy2|allergy3

Conformance Rule: Maximum character length set to ‘2000’. Note: Validator cannot enforce this so the rule is controlled through conformance.

Max Length0
11. List.contained
Definition

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.

Control0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained resources
Comments

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.

Max Length0
12. List.extension
Definition

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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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.

Max Length0
13. List.modifierExtension
Definition

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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content
Comments

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.

Max Length0
14. List.identifier
Definition

Identifier for the List assigned for business purposes outside the context of FHIR.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Max Length0
15. List.status
Definition

Indicates the current state of this list.

Control1..1
BindingThe codes SHALL be taken from ListStatus The current state of the list

Typecode
Is Modifiertrue
Must Supporttrue
Comments

Fixed value: current

Max Length0
Fixed Valuecurrent
16. List.mode
Definition

How this list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Control1..1
BindingThe codes SHALL be taken from ListMode The processing mode that applies to this list

Typecode
Is Modifiertrue
Must Supporttrue
Requirements

Lists are used in various ways, and it must be known in what way it is safe to use them.

Comments

Fixed value: snapshot

Max Length0
Fixed Valuesnapshot
17. List.title
Definition

A label for the list assigned by the author.

Control0..1
Typestring
Requirements

Allows customization beyond just the code identifying the kind of list.

Max Length0
Example
General:Dr. Jane's Patients
18. List.code
Definition

This code defines the purpose of the list - why it was created.

Control1..1
BindingFor example codes, see Example Use Codes for List What the purpose of a list is

TypeCodeableConcept
Must Supporttrue
Requirements

Lists often contain subsets of resources rather than an exhaustive list. The code identifies what type of subset is included.

Comments

For this codeable concept, 'coding' is mandatory and 'text' is not supported. Fixed values are defined for 'coding', refer to child elements.

Max Length0
19. List.code.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
Max Length0
20. List.code.extension
Definition

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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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.

Max Length0
21. List.code.coding
Definition

A reference to a code defined by a terminology system.

Control1..*
TypeCoding
Must Supporttrue
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.

Max Length0
SlicingThis element introduces a set of slices on List.code.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ system
22. List.code.coding:HL7Code
SliceNameHL7Code
Definition

A reference to a code defined by a terminology system.

Control1..*
TypeCoding
Must Supporttrue
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.

Max Length0
23. List.code.coding:HL7Code.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
Max Length0
24. List.code.coding:HL7Code.extension
Definition

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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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.

Max Length0
25. List.code.coding:HL7Code.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control1..1
Typeuri
Must Supporttrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Fixed value: http://hl7.org/fhir/list-example-use-codes

Max Length0
Fixed Valuehttp://hl7.org/fhir/list-example-use-codes
26. List.code.coding:HL7Code.version
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

NoteThis is a business versionId, not a resource version id (see discussion)
Control0..1
Typestring
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Max Length0
27. List.code.coding:HL7Code.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control1..1
Typecode
Must Supporttrue
Requirements

Need to refer to a particular code in the system.

Comments

Fixed value: allergies

Max Length0
Fixed Valueallergies
28. List.code.coding:HL7Code.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control0..1
Typestring
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Max Length0
29. List.code.coding:HL7Code.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control0..1
Typeboolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Max Length0
30. List.code.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control0..1
Typestring
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Max Length0
31. List.subject
Definition

The common subject (or patient) of the resources that are in the list, if there is one.

Control1..1
TypeReference(Patient | Group | Device | Location)
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Requirements

The primary purpose of listing the subject explicitly is to help with finding the right list.

Comments

-

Max Length0
32. List.encounter
Definition

The encounter that is the context in which this list was created.

Control0..1
TypeReference(Encounter)
Max Length0
33. List.date
Definition

The date that the list was prepared.

Control0..1
TypedateTime
Requirements

Identifies how current the list is which affects relevance.

Comments

The actual important date is the date of currency of the resources that were summarized, but it is usually assumed that these are current when the preparation occurs.

Max Length0
34. List.source
Definition

The entity responsible for deciding what the contents of the list were. Where the list was created by a human, this is the same as the author of the list.

Control0..1
TypeReference(Practitioner | Patient | Device)
Requirements

Allows follow-up as well as context.

Alternate NamesAuthor
Comments

The primary source is the entity that made the decisions what items are in the list. This may be software or user.

Max Length0
35. List.orderedBy
Definition

What order applies to the items in the list.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes What order applies to the items in a list

TypeCodeableConcept
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Max Length0
36. List.note
Definition

Comments that apply to the overall list.

Control0..*
TypeAnnotation
Max Length0
37. List.entry
Definition

Entries in this list.

Control0..* This element is affected by the following invariants: lst-1
TypeBackboneElement
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Max Length0
38. List.entry.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
Max Length0
39. List.entry.extension
Definition

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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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.

Max Length0
40. List.entry.modifierExtension
Definition

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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
Comments

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.

Max Length0
41. List.entry.flag
Definition

The flag allows the system constructing the list to indicate the role and significance of the item in the list.

Control0..1
BindingFor example codes, see Patient Medicine Change Types Codes that provide further information about the reason and meaning of the item in the list

TypeCodeableConcept
Requirements

This field is present to support various clinical uses of lists, such as a discharge summary medication list, where flags specify whether the medication was added, modified, or deleted from the list.

Comments

The flag can only be understood in the context of the List.code. If the flag means that the entry has actually been deleted from the list, the deleted element SHALL be true. Deleted can only be used if the List.mode is "changes".

Max Length0
42. List.entry.deleted
Definition

True if this item is marked as deleted in the list.

Control0..1 This element is affected by the following invariants: lst-2
Typeboolean
Is Modifiertrue
Requirements

The flag element may contain codes that an application processing the list does not understand. However there can be no ambiguity if a list item is actually marked as "deleted".

Comments

If the flag means that the entry has actually been deleted from the list, the deleted element SHALL be true. Both flag and deleted can only be used if the List.mode is "changes". A deleted entry should be displayed in narrative as deleted.

Max Length0
Default Valuefalse
43. List.entry.date
Definition

When this item was added to the list.

Control0..1
TypedateTime
Requirements

The date may be significant for understanding the meaning of items in a working list.

Comments

This is only useful and meaningful when the mode is "working".

Max Length0
44. List.entry.item
Definition

A reference to the actual resource from which data was derived.

Control1..1
TypeReference(Resource)
Max Length0
45. List.emptyReason
Definition

If the list is empty, why the list is empty.

Control0..1 This element is affected by the following invariants: lst-1
BindingThe codes SHOULD be taken from List Empty Reasons If a list is empty, why it is empty

TypeCodeableConcept
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty list make a significant interpretation to its interpretation. Note that this code is for use when the entire list has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Max Length0