FHIR Clinical Guidelines (v1.0.0) (STU1)

Clinical Practice Guidelines, published by Clinical Decision Support WG. This is not an authorized publication; it is the continuous build for version 1.0.0). This version is based on the current content of https://github.com/HL7/cqf-recommendations/ and changes regularly. See the Directory of published versions

D.4.1 StructureDefinition-cpg-detectedissue

Introduction:

Examples:

D.4.1.1 Formal Views of Profile Content

The official URL for this profile is:

http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-detectedissue

Documents a detected issue within the context of a computable clinical practice guideline

This profile builds on DetectedIssue.

This profile was published on Thu Jun 06 00:00:00 UTC 2019 as a draft by Health Level Seven, Inc. - CDS WG.

Description of Profiles, Differentials, and Snapshots.

NameFlagsCard.TypeDescription & Constraintsdoco
.. DetectedIssue 0..*DetectedIssueClinical issue with action
... cpg-instantiatesCaseFeature S0..1canonical(StructureDefinition)Definition of this case feature
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-instantiatesCaseFeature
... cpg-caseFeatureType S0..1codeasserted | inferred
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeatureType
Binding: CPG Case Feature Type (required): Whether the case feature is asserted or inferred

... cpg-caseFeaturePertinence S0..1codeweakly-positive | weakly-negative | strongly-positive | strongly-negative | pathognomonic
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeaturePertinence
Binding: CPG Case Feature Pertinence (required): Describes the pertinence of a case feature

... identifier 0..*IdentifierUnique id for the detected issue
... status S1..1coderegistered | preliminary | final | amended +
... code 1..1CodeableConceptIssue Category, e.g. drug-drug, duplicate therapy, etc.
... patient S0..1Reference(CPGPatient)Associated patient
... evidence S0..*BackboneElementSupporting evidence
.... code S0..*CodeableConceptManifestation
.... detail S0..*Reference(Resource)Supporting information

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. DetectedIssue 0..*DetectedIssueClinical issue with action
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages: A human language.

... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... cpg-instantiatesCaseFeature S0..1canonical(StructureDefinition)Definition of this case feature
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-instantiatesCaseFeature
... cpg-caseFeatureType S0..1codeasserted | inferred
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeatureType
Binding: CPG Case Feature Type (required): Whether the case feature is asserted or inferred


... cpg-caseFeaturePertinence S0..1codeweakly-positive | weakly-negative | strongly-positive | strongly-negative | pathognomonic
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeaturePertinence
Binding: CPG Case Feature Pertinence (required): Describes the pertinence of a case feature


... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierUnique id for the detected issue
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required): Indicates the status of the identified issue.

... code Σ1..1CodeableConceptIssue Category, e.g. drug-drug, duplicate therapy, etc.
Binding: DetectedIssueCategory (preferred): Codes identifying the general type of detected issue; e.g. Drug-drug interaction, Timing issue, Duplicate therapy, etc.

... severity Σ0..1codehigh | moderate | low
Binding: DetectedIssueSeverity (required): Indicates the potential degree of impact of the identified issue on the patient.

... patient SΣ0..1Reference(CPGPatient)Associated patient
... identified[x] Σ0..1When identified
.... identifiedDateTimedateTime
.... identifiedPeriodPeriod
... author Σ0..1Reference(Practitioner | PractitionerRole | Device)The provider or device that identified the issue
... implicated Σ0..*Reference(Resource)Problem resource
... evidence S0..*BackboneElementSupporting evidence
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code S0..*CodeableConceptManifestation
Binding: ManifestationAndSymptomCodes (example): Codes that describes the types of evidence for a detected issue.


.... detail S0..*Reference(Resource)Supporting information
... detail 0..1stringDescription and context
... reference 0..1uriAuthority for issue
... mitigation 0..*BackboneElementStep taken to address
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... action 1..1CodeableConceptWhat mitigation?
Binding: DetectedIssueMitigationAction (preferred): Codes describing steps taken to resolve the issue or other circumstances that mitigate the risk associated with the issue; e.g. 'added concurrent therapy', 'prior therapy documented', etc.

.... date 0..1dateTimeDate committed
.... author 0..1Reference(Practitioner | PractitionerRole)Who is committing?

doco Documentation for this format

Differential View

NameFlagsCard.TypeDescription & Constraintsdoco
.. DetectedIssue 0..*DetectedIssueClinical issue with action
... cpg-instantiatesCaseFeature S0..1canonical(StructureDefinition)Definition of this case feature
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-instantiatesCaseFeature
... cpg-caseFeatureType S0..1codeasserted | inferred
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeatureType
Binding: CPG Case Feature Type (required): Whether the case feature is asserted or inferred

... cpg-caseFeaturePertinence S0..1codeweakly-positive | weakly-negative | strongly-positive | strongly-negative | pathognomonic
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeaturePertinence
Binding: CPG Case Feature Pertinence (required): Describes the pertinence of a case feature

... identifier 0..*IdentifierUnique id for the detected issue
... status S1..1coderegistered | preliminary | final | amended +
... code 1..1CodeableConceptIssue Category, e.g. drug-drug, duplicate therapy, etc.
... patient S0..1Reference(CPGPatient)Associated patient
... evidence S0..*BackboneElementSupporting evidence
.... code S0..*CodeableConceptManifestation
.... detail S0..*Reference(Resource)Supporting information

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. DetectedIssue 0..*DetectedIssueClinical issue with action
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages: A human language.

... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... cpg-instantiatesCaseFeature S0..1canonical(StructureDefinition)Definition of this case feature
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-instantiatesCaseFeature
... cpg-caseFeatureType S0..1codeasserted | inferred
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeatureType
Binding: CPG Case Feature Type (required): Whether the case feature is asserted or inferred


... cpg-caseFeaturePertinence S0..1codeweakly-positive | weakly-negative | strongly-positive | strongly-negative | pathognomonic
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeaturePertinence
Binding: CPG Case Feature Pertinence (required): Describes the pertinence of a case feature


... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierUnique id for the detected issue
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required): Indicates the status of the identified issue.

... code Σ1..1CodeableConceptIssue Category, e.g. drug-drug, duplicate therapy, etc.
Binding: DetectedIssueCategory (preferred): Codes identifying the general type of detected issue; e.g. Drug-drug interaction, Timing issue, Duplicate therapy, etc.

... severity Σ0..1codehigh | moderate | low
Binding: DetectedIssueSeverity (required): Indicates the potential degree of impact of the identified issue on the patient.

... patient SΣ0..1Reference(CPGPatient)Associated patient
... identified[x] Σ0..1When identified
.... identifiedDateTimedateTime
.... identifiedPeriodPeriod
... author Σ0..1Reference(Practitioner | PractitionerRole | Device)The provider or device that identified the issue
... implicated Σ0..*Reference(Resource)Problem resource
... evidence S0..*BackboneElementSupporting evidence
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code S0..*CodeableConceptManifestation
Binding: ManifestationAndSymptomCodes (example): Codes that describes the types of evidence for a detected issue.


.... detail S0..*Reference(Resource)Supporting information
... detail 0..1stringDescription and context
... reference 0..1uriAuthority for issue
... mitigation 0..*BackboneElementStep taken to address
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... action 1..1CodeableConceptWhat mitigation?
Binding: DetectedIssueMitigationAction (preferred): Codes describing steps taken to resolve the issue or other circumstances that mitigate the risk associated with the issue; e.g. 'added concurrent therapy', 'prior therapy documented', etc.

.... date 0..1dateTimeDate committed
.... author 0..1Reference(Practitioner | PractitionerRole)Who is committing?

doco Documentation for this format

 

D.4.1.2 Terminology Bindings

Terminology Bindings

PathConformanceValueSet
DetectedIssue.languagepreferredCommonLanguages
Max Binding: AllLanguages
DetectedIssue.statusrequiredObservationStatus
DetectedIssue.codepreferredDetectedIssueCategory
DetectedIssue.severityrequiredDetectedIssueSeverity
DetectedIssue.evidence.codeexampleManifestationAndSymptomCodes
DetectedIssue.mitigation.actionpreferredDetectedIssueMitigationAction

D.4.1.3 Constraints

Constraints

IdPathDetailsRequirements
dom-2DetectedIssueIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3DetectedIssueIf 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-4DetectedIssueIf 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-5DetectedIssueIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6DetectedIssueA resource should have narrative for robust management
: text.`div`.exists()
ele-1DetectedIssue.metaAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1DetectedIssue.implicitRulesAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1DetectedIssue.languageAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1DetectedIssue.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1DetectedIssue.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1DetectedIssue.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1DetectedIssue.extension:instantiatesCaseFeatureAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1DetectedIssue.extension:instantiatesCaseFeatureMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1DetectedIssue.extension:caseFeatureTypeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1DetectedIssue.extension:caseFeatureTypeMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1DetectedIssue.extension:caseFeaturePertinenceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1DetectedIssue.extension:caseFeaturePertinenceMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1DetectedIssue.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1DetectedIssue.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1DetectedIssue.identifierAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1DetectedIssue.statusAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1DetectedIssue.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1DetectedIssue.severityAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1DetectedIssue.patientAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1DetectedIssue.identified[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1DetectedIssue.authorAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1DetectedIssue.implicatedAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1DetectedIssue.evidenceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1DetectedIssue.evidence.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1DetectedIssue.evidence.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1DetectedIssue.evidence.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1DetectedIssue.evidence.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1DetectedIssue.evidence.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1DetectedIssue.evidence.detailAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1DetectedIssue.detailAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1DetectedIssue.referenceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1DetectedIssue.mitigationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1DetectedIssue.mitigation.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1DetectedIssue.mitigation.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1DetectedIssue.mitigation.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1DetectedIssue.mitigation.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1DetectedIssue.mitigation.actionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1DetectedIssue.mitigation.dateAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1DetectedIssue.mitigation.authorAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())