Clinical Practice Guidelines
2.0.0-ballot - ballot International flag

Clinical Practice Guidelines, published by HL7 International / Clinical Decision Support. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/cqf-recommendations/ and changes regularly. See the Directory of published versions

Resource Profile: CPGComputablePlanDefinition - Detailed Descriptions

Active as of 2023-12-19

Definitions for the cpg-computableplandefinition resource profile.

Guidance on how to interpret the contents of this table can be found here

0. PlanDefinition
2. PlanDefinition.extension
SlicingThis element introduces a set of slices on PlanDefinition.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
4. PlanDefinition.extension:enabled
Slice Nameenabled
Control0..1
TypeExtension(CPG Enabled Extension) (Extension Type: boolean)
Must Supporttrue
6. PlanDefinition.extension:partOf
Slice NamepartOf
Control0..1
TypeExtension(CPG Part Of Extension) (Extension Type: canonical(PlanDefinition))
Must Supporttrue
8. PlanDefinition.type
Control1..?
Must Supporttrue
10. PlanDefinition.subject[x]
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
12. PlanDefinition.library
Control0..1
Must Supporttrue
14. PlanDefinition.action
Control1..?
Must Supporttrue
16. PlanDefinition.action.extension
SlicingThis element introduces a set of slices on PlanDefinition.action.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
18. PlanDefinition.action.extension:strengthOfRecommendation
Slice NamestrengthOfRecommendation
Control0..1
TypeExtension(Strength of recommendation) (Extension Type: CodeableConcept)
Must Supporttrue
20. PlanDefinition.action.extension:directionOfRecommendation
Slice NamedirectionOfRecommendation
Control0..1
TypeExtension(CPG Direction Of Recommendation Extension) (Extension Type: CodeableConcept)
Must Supporttrue
22. PlanDefinition.action.extension:qualityOfEvidence
Slice NamequalityOfEvidence
Control0..1
TypeExtension(Quality of evidence) (Extension Type: CodeableConcept)
Must Supporttrue
24. PlanDefinition.action.prefix
Must Supporttrue
26. PlanDefinition.action.title
Must Supporttrue
28. PlanDefinition.action.description
Must Supporttrue
30. PlanDefinition.action.code
Must Supporttrue
32. PlanDefinition.action.reason
Must Supporttrue
34. PlanDefinition.action.documentation
Must Supporttrue
36. PlanDefinition.action.trigger
Must Supporttrue
38. PlanDefinition.action.condition
Must Supporttrue
40. PlanDefinition.action.timing[x]
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
42. PlanDefinition.action.participant
Must Supporttrue
44. PlanDefinition.action.participant.role
BindingThe codes SHOULD be taken from CPG Common Persona Value Set

Personas used in identifying participants and their roles in computable content

Must Supporttrue
46. PlanDefinition.action.type
Must Supporttrue
48. PlanDefinition.action.definition[x]
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
50. PlanDefinition.action.dynamicValue
Must Supporttrue
52. PlanDefinition.action.dynamicValue.path
Must Supporttrue
54. PlanDefinition.action.dynamicValue.expression
Must Supporttrue
56. PlanDefinition.action.action
Must Supporttrue

Guidance on how to interpret the contents of this table can be found here

0. PlanDefinition
Definition

This resource allows for the definition of various types of plans as a sharable, consumable, and executable artifact. The resource is general enough to support the description of a broad range of clinical artifacts such as clinical decision support rules, order sets and protocols.

ShortThe definition of a plan for a series of actions, independent of any specific patient or context
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
pdf-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
pdf-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
2. PlanDefinition.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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. PlanDefinition.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
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.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on PlanDefinition.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
6. PlanDefinition.extension:enabled
Slice Nameenabled
Definition

Determines whether the artifact on which it appears is Enabled, as opposed to just Known.

ShortCPG Enabled Extension
Comments

Systems that are capable of storing and retrieving knowledge artifacts SHALL use this element to distinguish between a Known and an actively Enabled artifact. Behavior described by the artifact should only be implemented if this element is present and has a value of true.

Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(CPG Enabled Extension) (Extension Type: boolean)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. PlanDefinition.extension:partOf
Slice NamepartOf
Definition

Specifies the canonical URL of a Pathway or Strategy that this definition is part of.

ShortCPG Part Of Extension
Comments

For enrollment checking, if the computable PlanDefinition is not a Pathway or Strategy, then this extension is followed to attempt to determine a Pathway or Strategy to use for the enrollment check, recursively.

Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(CPG Part Of Extension) (Extension Type: canonical(PlanDefinition))
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. PlanDefinition.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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
12. PlanDefinition.type
Definition

A high-level category for the plan definition that distinguishes the kinds of systems that would be interested in the plan definition.

Shortorder-set | clinical-protocol | eca-rule | workflow-definition
Control10..1
BindingUnless not suitable, these codes SHALL be taken from PlanDefinitionTypehttp://hl7.org/fhir/ValueSet/plan-definition-type

The type of PlanDefinition.

TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. PlanDefinition.status
Definition

The status of this plan definition. Enables tracking the life-cycle of the content.

Shortdraft | active | retired | unknown
Comments

Allows filtering of plan definitions that are appropriate for use versus not.

Control1..1
BindingThe codes SHALL be taken from PublicationStatushttp://hl7.org/fhir/ValueSet/publication-status|4.0.1

The lifecycle status of an artifact.

Typecode
Is Modifiertrue because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. PlanDefinition.subject[x]
Definition

A code or group definition that describes the intended subject of the plan definition.

ShortType of individual the plan definition is focused on
Control0..1
BindingUnless not suitable, these codes SHALL be taken from SubjectTypehttp://hl7.org/fhir/ValueSet/subject-type

The possible types of subjects for a plan definition (E.g. Patient, Practitioner, Organization, Location, etc.).

TypeChoice of: CodeableConcept, Reference(Group)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifierfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summaryfalse
Meaning if MissingPatient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. PlanDefinition.library
Definition

A reference to a Library resource containing any formal logic used by the plan definition.

ShortLogic used by the plan definition
Control0..1*
Typecanonical(Library)
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. PlanDefinition.action
Definition

An action or group of actions to be taken as part of the plan.

ShortAction defined by the plan
Comments

Note that there is overlap between many of the elements defined here and the ActivityDefinition resource. When an ActivityDefinition is referenced (using the definition element), the overlapping elements in the plan override the content of the referenced ActivityDefinition unless otherwise documented in the specific elements. See the PlanDefinition resource for more detailed information.

Control10..*
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. PlanDefinition.action.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
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.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on PlanDefinition.action.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
24. PlanDefinition.action.extension:strengthOfRecommendation
Slice NamestrengthOfRecommendation
Definition

The strength of the recommendation assigned to this reference. The code system used specifies the rating scale used to rate this recommendation while the code specifies the actual recommendation rating (represented as a coded value) associated with this recommendation.

ShortThe strength of the recommendation
Control0..1
TypeExtension(Strength of recommendation) (Extension Type: CodeableConcept)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
26. PlanDefinition.action.extension:directionOfRecommendation
Slice NamedirectionOfRecommendation
Definition

Specifies whether the recommendation is "for" or "against" a particular activity. For example, the recommendation to prescribe a particular medication, versus the recommendation not to perform a particular procedure.

ShortCPG Direction Of Recommendation Extension
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(CPG Direction Of Recommendation Extension) (Extension Type: CodeableConcept)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
28. PlanDefinition.action.extension:qualityOfEvidence
Slice NamequalityOfEvidence
Definition

The quality of the evidence described. The code system used specifies the quality scale used to grade this evidence source while the code specifies the actual quality score (represented as a coded value) associated with the evidence.

ShortThe quality of the evidence
Control0..1
TypeExtension(Quality of evidence) (Extension Type: CodeableConcept)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
30. PlanDefinition.action.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
32. PlanDefinition.action.prefix
Definition

A user-visible prefix for the action.

ShortUser-visible prefix for the action (e.g. 1. or A.)
Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. PlanDefinition.action.title
Definition

The title of the action displayed to a user.

ShortUser-visible title
Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. PlanDefinition.action.description
Definition

A brief description of the action used to provide a summary to display to the user.

ShortBrief description of the action
Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. PlanDefinition.action.code
Definition

A code that provides meaning for the action or action group. For example, a section may have a LOINC code for the section of a documentation template.

ShortCode representing the meaning of the action or sub-actions
Control0..*
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. PlanDefinition.action.reason
Definition

A description of why this action is necessary or appropriate.

ShortWhy the action should be performed
Comments

This is different than the clinical evidence documentation, it's an actual business description of the reason for performing the action.

Control0..*
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. PlanDefinition.action.documentation
Definition

Didactic or other informational resources associated with the action that can be provided to the CDS recipient. Information resources can include inline text commentary and links to web resources.

ShortSupporting documentation for the intended performer of the action
Control0..*
TypeRelatedArtifact
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. PlanDefinition.action.trigger
Definition

A description of when the action should be triggered.

ShortWhen the action should be triggered
Control0..*
TypeTriggerDefinition
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. PlanDefinition.action.condition
Definition

An expression that describes applicability criteria or start/stop conditions for the action.

ShortWhether or not the action is applicable
Comments

When multiple conditions of the same kind are present, the effects are combined using AND semantics, so the overall condition is true only if all the conditions are true.

Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. PlanDefinition.action.condition.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
50. PlanDefinition.action.condition.kind
Definition

The kind of condition.

Shortapplicability | start | stop
Comments

Applicability criteria are used to determine immediate applicability when a plan definition is applied to a given context. Start and stop criteria are carried through application and used to describe enter/exit criteria for an action.

Control1..1
BindingThe codes SHALL be taken from ActionConditionKindhttp://hl7.org/fhir/ValueSet/action-condition-kind|4.0.1

Defines the kinds of conditions that can appear on actions.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. PlanDefinition.action.timing[x]
Definition

An optional value describing when the action should be performed.

ShortWhen the action should take place
Control0..1
TypeChoice of: dateTime, Age, Period, Duration, Range, Timing
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. PlanDefinition.action.participant
Definition

Indicates who should participate in performing the action described.

ShortWho should participate in the action
Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. PlanDefinition.action.participant.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
58. PlanDefinition.action.participant.type
Definition

The type of participant in the action.

Shortpatient | practitioner | related-person | device
Control1..1
BindingThe codes SHALL be taken from ActionParticipantTypehttp://hl7.org/fhir/ValueSet/action-participant-type|4.0.1

The type of participant for the action.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. PlanDefinition.action.participant.role
Definition

The role the participant should play in performing the described action.

ShortE.g. Nurse, Surgeon, Parent
Control0..1
BindingThe codes SHOULD be taken from For example codes, see CPG Common Persona Value Sethttp://hl7.org/fhir/ValueSet/action-participant-role

Personas used in identifying participants and their roles in computable content


Defines roles played by participants for the action.

TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. PlanDefinition.action.type
Definition

The type of action to perform (create, update, remove).

Shortcreate | update | remove | fire-event
Control0..1
BindingUnless not suitable, these codes SHALL be taken from ActionTypehttp://hl7.org/fhir/ValueSet/action-type

The type of action to be performed.

TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. PlanDefinition.action.definition[x]
Definition

A reference to an ActivityDefinition that describes the action to be taken in detail, or a PlanDefinition that describes a series of actions to be taken.

ShortDescription of the activity to be performed
Comments

Note that the definition is optional, and if no definition is specified, a dynamicValue with a root ($this) path can be used to define the entire resource dynamically.

Control0..1
TypeChoice of: canonical(ActivityDefinition, PlanDefinition, Questionnaire), uri
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
66. PlanDefinition.action.dynamicValue
Definition

Customizations that should be applied to the statically defined resource. For example, if the dosage of a medication must be computed based on the patient's weight, a customization would be used to specify an expression that calculated the weight, and the path on the resource that would contain the result.

ShortDynamic aspects of the definition
Comments

Dynamic values are applied in the order in which they are defined in the PlanDefinition resource. Note that when dynamic values are also specified by a referenced ActivityDefinition, the dynamicValues from the ActivityDefinition are applied first, followed by the dynamicValues specified here. In addition, if both a transform and dynamic values are specific, the dynamic values are applied to the result of the transform.

Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. PlanDefinition.action.dynamicValue.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
70. PlanDefinition.action.dynamicValue.path
Definition

The path to the element to be customized. This is the path on the resource that will hold the result of the calculation defined by the expression. The specified path SHALL be a FHIRPath resolveable on the specified target type of the ActivityDefinition, and SHALL consist only of identifiers, constant indexers, and a restricted subset of functions. The path is allowed to contain qualifiers (.) to traverse sub-elements, as well as indexers ([x]) to traverse multiple-cardinality sub-elements (see the Simple FHIRPath Profile for full details).

ShortThe path to the element to be set dynamically
Comments

To specify the path to the current action being realized, the %action environment variable is available in this path. For example, to specify the description element of the target action, the path would be %action.description. The path attribute contains a Simple FHIRPath Subset that allows path traversal, but not calculation.

Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
72. PlanDefinition.action.dynamicValue.expression
Definition

An expression specifying the value of the customized element.

ShortAn expression that provides the dynamic value for the customization
Comments

The expression may be inlined or may be a reference to a named expression within a logic library referenced by the library element.

Control0..1
TypeExpression
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
74. PlanDefinition.action.action
Definition

Sub actions that are contained within the action. The behavior of this action determines the functionality of the sub-actions. For example, a selection behavior of at-most-one indicates that of the sub-actions, at most one may be chosen as part of realizing the action definition.

ShortA sub-action
Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/PlanDefinition#PlanDefinition.action
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be found here

0. PlanDefinition
Definition

This resource allows for the definition of various types of plans as a sharable, consumable, and executable artifact. The resource is general enough to support the description of a broad range of clinical artifacts such as clinical decision support rules, order sets and protocols.

ShortThe definition of a plan for a series of actions, independent of any specific patient or context
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
pdf-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
2. PlanDefinition.id
Definition

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

ShortLogical id of this artifact
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control0..1
Typeid
Is Modifierfalse
Summarytrue
4. PlanDefinition.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

ShortMetadata about the resource
Control0..1
TypeMeta
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. PlanDefinition.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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. PlanDefinition.language
Definition

The base language in which the resource is written.

ShortLanguage of the resource content
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).

Control0..1
BindingThe codes SHOULD be taken from CommonLanguages

A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. PlanDefinition.text
Definition

A human-readable narrative that contains a summary of the resource and can 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.

ShortText summary of the resource, for human interpretation
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Control0..1
TypeNarrative
Is Modifierfalse
Summaryfalse
Alternate Namesnarrative, html, xhtml, display
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. PlanDefinition.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.

ShortContained, inline 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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Control0..*
TypeResource
Is Modifierfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
14. PlanDefinition.extension
Definition

An Extension

ShortExtension
Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on PlanDefinition.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
16. PlanDefinition.extension:enabled
Slice Nameenabled
Definition

Determines whether the artifact on which it appears is Enabled, as opposed to just Known.

ShortCPG Enabled Extension
Comments

Systems that are capable of storing and retrieving knowledge artifacts SHALL use this element to distinguish between a Known and an actively Enabled artifact. Behavior described by the artifact should only be implemented if this element is present and has a value of true.

Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(CPG Enabled Extension) (Extension Type: boolean)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. PlanDefinition.extension:partOf
Slice NamepartOf
Definition

Specifies the canonical URL of a Pathway or Strategy that this definition is part of.

ShortCPG Part Of Extension
Comments

For enrollment checking, if the computable PlanDefinition is not a Pathway or Strategy, then this extension is followed to attempt to determine a Pathway or Strategy to use for the enrollment check, recursively.

Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(CPG Part Of Extension) (Extension Type: canonical(PlanDefinition))
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
20. PlanDefinition.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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
22. PlanDefinition.url
Definition

An absolute URI that is used to identify this plan definition when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this plan definition is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the plan definition is stored on different servers.

ShortCanonical identifier for this plan definition, represented as a URI (globally unique)
Comments

Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version.

The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in Technical and Business Versions.

In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the meta.source element to indicate where the current master source of the resource can be found.

Control0..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the plan definition to be referenced by a single globally unique identifier.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. PlanDefinition.identifier
Definition

A formal identifier that is used to identify this plan definition when it is represented in other formats, or referenced in a specification, model, design or an instance.

ShortAdditional identifier for the plan definition
Comments

Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this plan definition outside of FHIR, where it is not possible to use the logical URI.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Summarytrue
Requirements

Allows externally provided and/or usable business identifiers to be easily associated with the module.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. PlanDefinition.version
Definition

The identifier that is used to identify this version of the plan definition when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the plan definition author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. To provide a version consistent with the Decision Support Service specification, use the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer to the Decision Support Service specification. Note that a version is required for non-experimental active artifacts.

ShortBusiness version of the plan definition
Comments

There may be different plan definition instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the plan definition with the format [url]|[version].

NoteThis is a business versionId, not a resource version id (see discussion)
Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. PlanDefinition.name
Definition

A natural language name identifying the plan definition. This name should be usable as an identifier for the module by machine processing applications such as code generation.

ShortName for this plan definition (computer friendly)
Comments

The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

Control0..1
This element is affected by the following invariants: inv-0
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Support human navigation and code generation.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. PlanDefinition.title
Definition

A short, descriptive, user-friendly title for the plan definition.

ShortName for this plan definition (human friendly)
Comments

This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. PlanDefinition.subtitle
Definition

An explanatory or alternate title for the plan definition giving additional information about its content.

ShortSubordinate title of the plan definition
Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. PlanDefinition.type
Definition

A high-level category for the plan definition that distinguishes the kinds of systems that would be interested in the plan definition.

Shortorder-set | clinical-protocol | eca-rule | workflow-definition
Control1..1
BindingUnless not suitable, these codes SHALL be taken from PlanDefinitionType

The type of PlanDefinition.

TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. PlanDefinition.status
Definition

The status of this plan definition. Enables tracking the life-cycle of the content.

Shortdraft | active | retired | unknown
Comments

Allows filtering of plan definitions that are appropriate for use versus not.

Control1..1
BindingThe codes SHALL be taken from PublicationStatus

The lifecycle status of an artifact.

Typecode
Is Modifiertrue because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. PlanDefinition.experimental
Definition

A Boolean value to indicate that this plan definition is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.

ShortFor testing purposes, not real usage
Comments

Allows filtering of plan definitions that are appropriate for use versus not.

Control0..1
Typeboolean
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Enables experimental content to be developed following the same lifecycle that would be used for a production-level plan definition.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. PlanDefinition.subject[x]
Definition

A code or group definition that describes the intended subject of the plan definition.

ShortType of individual the plan definition is focused on
Control0..1
BindingUnless not suitable, these codes SHALL be taken from SubjectType

The possible types of subjects for a plan definition (E.g. Patient, Practitioner, Organization, Location, etc.).

TypeChoice of: CodeableConcept, Reference(Group)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifierfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summaryfalse
Meaning if MissingPatient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. PlanDefinition.date
Definition

The date (and optionally time) when the plan definition was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the plan definition changes.

ShortDate last changed
Comments

Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the plan definition. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

Control0..1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate NamesRevision Date
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. PlanDefinition.publisher
Definition

The name of the organization or individual that published the plan definition.

ShortName of the publisher (organization or individual)
Comments

Usually an organization but may be an individual. The publisher (or steward) of the plan definition is the organization or individual primarily responsible for the maintenance and upkeep of the plan definition. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the plan definition. This item SHOULD be populated unless the information is available from context.

Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Helps establish the "authority/credibility" of the plan definition. May also allow for contact.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. PlanDefinition.contact
Definition

Contact details to assist a user in finding and communicating with the publisher.

ShortContact details for the publisher
Comments

May be a web site, an email address, a telephone number, etc.

Control0..*
TypeContactDetail
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. PlanDefinition.description
Definition

A free text natural language description of the plan definition from a consumer's perspective.

ShortNatural language description of the plan definition
Comments

This description can be used to capture details such as why the plan definition was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the plan definition as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the plan definition is presumed to be the predominant language in the place the plan definition was created).

Control0..1
Typemarkdown
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. PlanDefinition.useContext
Definition

The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate plan definition instances.

ShortThe context that the content is intended to support
Comments

When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

Control0..*
TypeUsageContext
Is Modifierfalse
Summarytrue
Requirements

Assist in searching for appropriate content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. PlanDefinition.jurisdiction
Definition

A legal or geographic region in which the plan definition is intended to be used.

ShortIntended jurisdiction for plan definition (if applicable)
Comments

It may be possible for the plan definition to be used in jurisdictions other than those for which it was originally designed or intended.

Control0..*
BindingUnless not suitable, these codes SHALL be taken from Jurisdiction ValueSet

Countries and regions within which this artifact is targeted for use.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. PlanDefinition.purpose
Definition

Explanation of why this plan definition is needed and why it has been designed as it has.

ShortWhy this plan definition is defined
Comments

This element does not describe the usage of the plan definition. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this plan definition.

Control0..1
Typemarkdown
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. PlanDefinition.usage
Definition

A detailed description of how the plan definition is used from a clinical perspective.

ShortDescribes the clinical usage of the plan
Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. PlanDefinition.copyright
Definition

A copyright statement relating to the plan definition and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the plan definition.

ShortUse and/or publishing restrictions
Control0..1
Typemarkdown
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Requirements

Consumers must be able to determine any legal restrictions on the use of the plan definition and/or its content.

Alternate NamesLicense, Restrictions
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. PlanDefinition.approvalDate
Definition

The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.

ShortWhen the plan definition was approved by publisher
Comments

The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.

Control0..1
Typedate
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. PlanDefinition.lastReviewDate
Definition

The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.

ShortWhen the plan definition was last reviewed
Comments

If specified, this date follows the original approval date.

Control0..1
Typedate
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Requirements

Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. PlanDefinition.effectivePeriod
Definition

The period during which the plan definition content was or is planned to be in active use.

ShortWhen the plan definition is expected to be used
Comments

The effective period for a plan definition determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015.

Control0..1
TypePeriod
Is Modifierfalse
Summarytrue
Requirements

Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of the plan definition are or are expected to be used instead.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
66. PlanDefinition.topic
Definition

Descriptive topics related to the content of the plan definition. Topics provide a high-level categorization of the definition that can be useful for filtering and searching.

ShortE.g. Education, Treatment, Assessment
Control0..*
BindingFor example codes, see DefinitionTopic

High-level categorization of the definition, used for searching, sorting, and filtering.

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Requirements

Repositories must be able to determine how to categorize the plan definition so that it can be found by topical searches.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. PlanDefinition.author
Definition

An individiual or organization primarily involved in the creation and maintenance of the content.

ShortWho authored the content
Control0..*
TypeContactDetail
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
70. PlanDefinition.editor
Definition

An individual or organization primarily responsible for internal coherence of the content.

ShortWho edited the content
Control0..*
TypeContactDetail
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
72. PlanDefinition.reviewer
Definition

An individual or organization primarily responsible for review of some aspect of the content.

ShortWho reviewed the content
Control0..*
TypeContactDetail
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
74. PlanDefinition.endorser
Definition

An individual or organization responsible for officially endorsing the content for use in some setting.

ShortWho endorsed the content
Control0..*
TypeContactDetail
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
76. PlanDefinition.relatedArtifact
Definition

Related artifacts such as additional documentation, justification, or bibliographic references.

ShortAdditional documentation, citations
Comments

Each related artifact is either an attachment, or a reference to another resource, but not both.

Control0..*
TypeRelatedArtifact
Is Modifierfalse
Summaryfalse
Requirements

Plan definitions must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
78. PlanDefinition.library
Definition

A reference to a Library resource containing any formal logic used by the plan definition.

ShortLogic used by the plan definition
Control0..1
Typecanonical(Library)
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
80. PlanDefinition.goal
Definition

Goals that describe what the activities within the plan are intended to achieve. For example, weight loss, restoring an activity of daily living, obtaining herd immunity via immunization, meeting a process improvement objective, etc.

ShortWhat the plan is trying to accomplish
Control0..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Requirements

Goal information needs to be captured for order sets, protocols, and care plan definitions to better describe the objectives of the protocol activities and to guide the creation of specific goals within the derived care plans and orders.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
82. PlanDefinition.goal.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
84. PlanDefinition.goal.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
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.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
86. PlanDefinition.goal.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
88. PlanDefinition.goal.category
Definition

Indicates a category the goal falls within.

ShortE.g. Treatment, dietary, behavioral
Control0..1
BindingFor example codes, see GoalCategory

Example codes for grouping goals for filtering or presentation.

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
90. PlanDefinition.goal.description
Definition

Human-readable and/or coded description of a specific desired objective of care, such as "control blood pressure" or "negotiate an obstacle course" or "dance with child at wedding".

ShortCode or text describing the goal
Comments

If no code is available, use CodeableConcept.text.

Control1..1
BindingFor example codes, see SNOMEDCTClinicalFindings

Describes goals that can be achieved.

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
92. PlanDefinition.goal.priority
Definition

Identifies the expected level of importance associated with reaching/sustaining the defined goal.

Shorthigh-priority | medium-priority | low-priority
Control0..1
BindingThe codes SHOULD be taken from GoalPriority

Indicates the level of importance associated with reaching or sustaining a goal.

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
94. PlanDefinition.goal.start
Definition

The event after which the goal should begin being pursued.

ShortWhen goal pursuit begins
Control0..1
BindingFor example codes, see GoalStartEvent

Identifies the types of events that might trigger the start of a goal.

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
96. PlanDefinition.goal.addresses
Definition

Identifies problems, conditions, issues, or concerns the goal is intended to address.

ShortWhat does the goal address
Control0..*
BindingFor example codes, see Condition/Problem/DiagnosisCodes

Identifies problems, conditions, issues, or concerns that goals may address.

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
98. PlanDefinition.goal.documentation
Definition

Didactic or other informational resources associated with the goal that provide further supporting information about the goal. Information resources can include inline text commentary and links to web resources.

ShortSupporting documentation for the goal
Control0..*
TypeRelatedArtifact
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
100. PlanDefinition.goal.target
Definition

Indicates what should be done and within what timeframe.

ShortTarget outcome for the goal
Control0..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
102. PlanDefinition.goal.target.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
104. PlanDefinition.goal.target.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
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.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
106. PlanDefinition.goal.target.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
108. PlanDefinition.goal.target.measure
Definition

The parameter whose value is to be tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.

ShortThe parameter whose value is to be tracked
Control0..1
BindingFor example codes, see LOINCCodes

Identifies types of parameters that can be tracked to determine goal achievement.

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
110. PlanDefinition.goal.target.detail[x]
Definition

The target value of the measure to be achieved to signify fulfillment of the goal, e.g. 150 pounds or 7.0%. Either the high or low or both values of the range can be specified. When a low value is missing, it indicates that the goal is achieved at any value at or below the high value. Similarly, if the high value is missing, it indicates that the goal is achieved at any value at or above the low value.

ShortThe target value to be achieved
Control0..1
TypeChoice of: Quantity, Range, CodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
112. PlanDefinition.goal.target.due
Definition

Indicates the timeframe after the start of the goal in which the goal should be met.

ShortReach goal within
Control0..1
TypeDuration
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
114. PlanDefinition.action
Definition

An action or group of actions to be taken as part of the plan.

ShortAction defined by the plan
Comments

Note that there is overlap between many of the elements defined here and the ActivityDefinition resource. When an ActivityDefinition is referenced (using the definition element), the overlapping elements in the plan override the content of the referenced ActivityDefinition unless otherwise documented in the specific elements. See the PlanDefinition resource for more detailed information.

Control1..*
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
116. PlanDefinition.action.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
118. PlanDefinition.action.extension
Definition

An Extension

ShortExtension
Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on PlanDefinition.action.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
120. PlanDefinition.action.extension:strengthOfRecommendation
Slice NamestrengthOfRecommendation
Definition

The strength of the recommendation assigned to this reference. The code system used specifies the rating scale used to rate this recommendation while the code specifies the actual recommendation rating (represented as a coded value) associated with this recommendation.

ShortThe strength of the recommendation
Control0..1
TypeExtension(Strength of recommendation) (Extension Type: CodeableConcept)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
122. PlanDefinition.action.extension:directionOfRecommendation
Slice NamedirectionOfRecommendation
Definition

Specifies whether the recommendation is "for" or "against" a particular activity. For example, the recommendation to prescribe a particular medication, versus the recommendation not to perform a particular procedure.

ShortCPG Direction Of Recommendation Extension
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(CPG Direction Of Recommendation Extension) (Extension Type: CodeableConcept)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
124. PlanDefinition.action.extension:qualityOfEvidence
Slice NamequalityOfEvidence
Definition

The quality of the evidence described. The code system used specifies the quality scale used to grade this evidence source while the code specifies the actual quality score (represented as a coded value) associated with the evidence.

ShortThe quality of the evidence
Control0..1
TypeExtension(Quality of evidence) (Extension Type: CodeableConcept)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
126. PlanDefinition.action.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
128. PlanDefinition.action.prefix
Definition

A user-visible prefix for the action.

ShortUser-visible prefix for the action (e.g. 1. or A.)
Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
130. PlanDefinition.action.title
Definition

The title of the action displayed to a user.

ShortUser-visible title
Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
132. PlanDefinition.action.description
Definition

A brief description of the action used to provide a summary to display to the user.

ShortBrief description of the action
Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
134. PlanDefinition.action.textEquivalent
Definition

A text equivalent of the action to be performed. This provides a human-interpretable description of the action when the definition is consumed by a system that might not be capable of interpreting it dynamically.

ShortStatic text equivalent of the action, used if the dynamic aspects cannot be interpreted by the receiving system
Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
136. PlanDefinition.action.priority
Definition

Indicates how quickly the action should be addressed with respect to other actions.

Shortroutine | urgent | asap | stat
Control0..1
BindingThe codes SHALL be taken from RequestPriority

Identifies the level of importance to be assigned to actioning the request.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
138. PlanDefinition.action.code
Definition

A code that provides meaning for the action or action group. For example, a section may have a LOINC code for the section of a documentation template.

ShortCode representing the meaning of the action or sub-actions
Control0..*
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
140. PlanDefinition.action.reason
Definition

A description of why this action is necessary or appropriate.

ShortWhy the action should be performed
Comments

This is different than the clinical evidence documentation, it's an actual business description of the reason for performing the action.

Control0..*
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
142. PlanDefinition.action.documentation
Definition

Didactic or other informational resources associated with the action that can be provided to the CDS recipient. Information resources can include inline text commentary and links to web resources.

ShortSupporting documentation for the intended performer of the action
Control0..*
TypeRelatedArtifact
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
144. PlanDefinition.action.goalId
Definition

Identifies goals that this action supports. The reference must be to a goal element defined within this plan definition.

ShortWhat goals this action supports
Control0..*
Typeid
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
146. PlanDefinition.action.subject[x]
Definition

A code or group definition that describes the intended subject of the action and its children, if any.

ShortType of individual the action is focused on
Comments

The subject of an action overrides the subject at a parent action or on the root of the PlanDefinition if specified.

In addition, because the subject needs to be resolved during realization, use of subjects in actions (or in the ActivityDefinition referenced by the action) resolves based on the set of subjects supplied in context and by type (i.e. the patient subject would resolve to a resource of type Patient).

Control0..1
BindingUnless not suitable, these codes SHALL be taken from SubjectType

The possible types of subjects for a plan definition (E.g. Patient, Practitioner, Organization, Location, etc.).

TypeChoice of: CodeableConcept, Reference(Group)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifierfalse
Summaryfalse
Requirements

Multiple steps in a protocol often have different groups of steps that are focused on testing different things. The subject of an action specifies the focus of the action and any child actions.

Meaning if MissingPatient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
148. PlanDefinition.action.trigger
Definition

A description of when the action should be triggered.

ShortWhen the action should be triggered
Control0..*
TypeTriggerDefinition
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
150. PlanDefinition.action.condition
Definition

An expression that describes applicability criteria or start/stop conditions for the action.

ShortWhether or not the action is applicable
Comments

When multiple conditions of the same kind are present, the effects are combined using AND semantics, so the overall condition is true only if all the conditions are true.

Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
152. PlanDefinition.action.condition.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
154. PlanDefinition.action.condition.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
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.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
156. PlanDefinition.action.condition.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
158. PlanDefinition.action.condition.kind
Definition

The kind of condition.

Shortapplicability | start | stop
Comments

Applicability criteria are used to determine immediate applicability when a plan definition is applied to a given context. Start and stop criteria are carried through application and used to describe enter/exit criteria for an action.

Control1..1
BindingThe codes SHALL be taken from ActionConditionKind

Defines the kinds of conditions that can appear on actions.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
160. PlanDefinition.action.condition.expression
Definition

An expression that returns true or false, indicating whether the condition is satisfied.

ShortBoolean-valued expression
Comments

The expression may be inlined or may be a reference to a named expression within a logic library referenced by the library element.

Control0..1
TypeExpression
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
162. PlanDefinition.action.input
Definition

Defines input data requirements for the action.

ShortInput data requirements
Control0..*
TypeDataRequirement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
164. PlanDefinition.action.output
Definition

Defines the outputs of the action, if any.

ShortOutput data definition
Control0..*
TypeDataRequirement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
166. PlanDefinition.action.relatedAction
Definition

A relationship to another action such as "before" or "30-60 minutes after start of".

ShortRelationship to another action
Comments

When an action depends on multiple actions, the meaning is that all actions are dependencies, rather than that any of the actions are a dependency.

Control0..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
168. PlanDefinition.action.relatedAction.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
170. PlanDefinition.action.relatedAction.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
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.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
172. PlanDefinition.action.relatedAction.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
174. PlanDefinition.action.relatedAction.actionId
Definition

The element id of the related action.

ShortWhat action is this related to
Control1..1
Typeid
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
176. PlanDefinition.action.relatedAction.relationship
Definition

The relationship of this action to the related action.

Shortbefore-start | before | before-end | concurrent-with-start | concurrent | concurrent-with-end | after-start | after | after-end
Control1..1
BindingThe codes SHALL be taken from ActionRelationshipType

Defines the types of relationships between actions.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
178. PlanDefinition.action.relatedAction.offset[x]
Definition

A duration or range of durations to apply to the relationship. For example, 30-60 minutes before.

ShortTime offset for the relationship
Control0..1
TypeChoice of: Duration, Range
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
180. PlanDefinition.action.timing[x]
Definition

An optional value describing when the action should be performed.

ShortWhen the action should take place
Control0..1
TypeChoice of: dateTime, Age, Period, Duration, Range, Timing
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
182. PlanDefinition.action.participant
Definition

Indicates who should participate in performing the action described.

ShortWho should participate in the action
Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
184. PlanDefinition.action.participant.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
186. PlanDefinition.action.participant.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
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.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
188. PlanDefinition.action.participant.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
190. PlanDefinition.action.participant.type
Definition

The type of participant in the action.

Shortpatient | practitioner | related-person | device
Control1..1
BindingThe codes SHALL be taken from ActionParticipantType

The type of participant for the action.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
192. PlanDefinition.action.participant.role
Definition

The role the participant should play in performing the described action.

ShortE.g. Nurse, Surgeon, Parent
Control0..1
BindingThe codes SHOULD be taken from CPG Common Persona Value Set

Personas used in identifying participants and their roles in computable content

TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
194. PlanDefinition.action.type
Definition

The type of action to perform (create, update, remove).

Shortcreate | update | remove | fire-event
Control0..1
BindingUnless not suitable, these codes SHALL be taken from ActionType

The type of action to be performed.

TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
196. PlanDefinition.action.groupingBehavior
Definition

Defines the grouping behavior for the action and its children.

Shortvisual-group | logical-group | sentence-group
Control0..1
BindingThe codes SHALL be taken from ActionGroupingBehavior

Defines organization behavior of a group.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
198. PlanDefinition.action.selectionBehavior
Definition

Defines the selection behavior for the action and its children.

Shortany | all | all-or-none | exactly-one | at-most-one | one-or-more
Control0..1
BindingThe codes SHALL be taken from ActionSelectionBehavior

Defines selection behavior of a group.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
200. PlanDefinition.action.requiredBehavior
Definition

Defines the required behavior for the action.

Shortmust | could | must-unless-documented
Control0..1
BindingThe codes SHALL be taken from ActionRequiredBehavior

Defines expectations around whether an action or action group is required.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
202. PlanDefinition.action.precheckBehavior
Definition

Defines whether the action should usually be preselected.

Shortyes | no
Control0..1
BindingThe codes SHALL be taken from ActionPrecheckBehavior

Defines selection frequency behavior for an action or group.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
204. PlanDefinition.action.cardinalityBehavior
Definition

Defines whether the action can be selected multiple times.

Shortsingle | multiple
Control0..1
BindingThe codes SHALL be taken from ActionCardinalityBehavior

Defines behavior for an action or a group for how many times that item may be repeated.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
206. PlanDefinition.action.definition[x]
Definition

A reference to an ActivityDefinition that describes the action to be taken in detail, or a PlanDefinition that describes a series of actions to be taken.

ShortDescription of the activity to be performed
Comments

Note that the definition is optional, and if no definition is specified, a dynamicValue with a root ($this) path can be used to define the entire resource dynamically.

Control0..1
TypeChoice of: canonical(ActivityDefinition, PlanDefinition, Questionnaire), uri
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
208. PlanDefinition.action.transform
Definition

A reference to a StructureMap resource that defines a transform that can be executed to produce the intent resource using the ActivityDefinition instance as the input.

ShortTransform to apply the template
Comments

Note that when a referenced ActivityDefinition also defines a transform, the transform specified here generally takes precedence. In addition, if both a transform and dynamic values are specific, the dynamic values are applied to the result of the transform.

Control0..1
Typecanonical(StructureMap)
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
210. PlanDefinition.action.dynamicValue
Definition

Customizations that should be applied to the statically defined resource. For example, if the dosage of a medication must be computed based on the patient's weight, a customization would be used to specify an expression that calculated the weight, and the path on the resource that would contain the result.

ShortDynamic aspects of the definition
Comments

Dynamic values are applied in the order in which they are defined in the PlanDefinition resource. Note that when dynamic values are also specified by a referenced ActivityDefinition, the dynamicValues from the ActivityDefinition are applied first, followed by the dynamicValues specified here. In addition, if both a transform and dynamic values are specific, the dynamic values are applied to the result of the transform.

Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
212. PlanDefinition.action.dynamicValue.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
214. PlanDefinition.action.dynamicValue.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
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.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
216. PlanDefinition.action.dynamicValue.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
218. PlanDefinition.action.dynamicValue.path
Definition

The path to the element to be customized. This is the path on the resource that will hold the result of the calculation defined by the expression. The specified path SHALL be a FHIRPath resolveable on the specified target type of the ActivityDefinition, and SHALL consist only of identifiers, constant indexers, and a restricted subset of functions. The path is allowed to contain qualifiers (.) to traverse sub-elements, as well as indexers ([x]) to traverse multiple-cardinality sub-elements (see the Simple FHIRPath Profile for full details).

ShortThe path to the element to be set dynamically
Comments

To specify the path to the current action being realized, the %action environment variable is available in this path. For example, to specify the description element of the target action, the path would be %action.description. The path attribute contains a Simple FHIRPath Subset that allows path traversal, but not calculation.

Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
220. PlanDefinition.action.dynamicValue.expression
Definition

An expression specifying the value of the customized element.

ShortAn expression that provides the dynamic value for the customization
Comments

The expression may be inlined or may be a reference to a named expression within a logic library referenced by the library element.

Control0..1
TypeExpression
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
222. PlanDefinition.action.action
Definition

Sub actions that are contained within the action. The behavior of this action determines the functionality of the sub-actions. For example, a selection behavior of at-most-one indicates that of the sub-actions, at most one may be chosen as part of realizing the action definition.

ShortA sub-action
Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/PlanDefinition#PlanDefinition.action
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))