Clinical Practice Guidelines
3.0.0-ballot - STU 3 Ballot
Clinical Practice Guidelines
3.0.0-ballot - STU 3 Ballot
Clinical Practice Guidelines, published by HL7 International / Clinical Decision Support. This guide is not an authorized publication; it is the continuous build for version 3.0.0-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
| Official URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-detectedissue | Version: 3.0.0-ballot | ||||
| Active as of 2026-11-10 | Computable Name: CPGDetectedIssue | ||||
| Other Identifiers: OID:2.16.840.1.113883.4.642.40.48.42.48 | |||||
Documents a detected issue within the context of a computable clinical practice guideline
This is a domain case/instance profile
Usages:
You can also check for usages in the FHIR IG Statistics
Description Differentials, Snapshots, and other representations.
| Name | Flags | Card. | Type | Description & Constraints Filter:  |
|---|---|---|---|---|
  DetectedIssue |
0..* | DetectedIssue | Clinical issue with action | |
  implicitRules |
0..1 | uri | A set of rules under which this content was created | |
  Slices for extension |
0..* | Extension | Extension Slice: Unordered, Open by value:url | |
   extension:pertinenceRating |
0..1 | integer | CPG Pertinence Rating Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-pertinenceRating | |
| extension:pertinentTo |
0..1 | Reference() | CPG Pertinent To Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-pertinentTo | |
| extension:instantiatesCaseFeature |
0..1 | canonical(CPG Case Feature Definition) | CPG Instantiates Case Feature Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-instantiatesCaseFeature | |
| extension:caseFeatureType |
0..1 | code | CPG Case Feature Type Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeatureType Binding: CPG Case Feature Type Value Set (required): Whether the case feature is asserted or inferred | |
 extension:caseFeaturePertinence |
0..1 | code | CPG Case Feature Pertinence Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeaturePertinence Binding: CPG Case Feature Pertinence Value Set (required): Describes the pertinence of a case feature | |
 modifierExtension |
0..* | Extension | Extensions that cannot be ignored | |
| status |
1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Indicates the status of the identified issue. | |
 code |
1..1 | CodeableConcept | Issue 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. | |
 patient |
0..1 | Reference(CPG Patient) | Associated patient | |
 evidence |
0..* | BackboneElement | Supporting evidence | |
 modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| code |
0..* | CodeableConcept | Manifestation Binding: ManifestationAndSymptomCodes (example): Codes that describes the types of evidence for a detected issue. | |
 detail |
0..* | Reference(Resource) | Supporting information | |
| Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| DetectedIssue.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std. |
| DetectedIssue.code | Base | preferred | Detected Issue Category | 📍4.0.1 | FHIR Std. |
| DetectedIssue.evidence.code | Base | example | Manifestation and Symptom Codes | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | DetectedIssue | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | DetectedIssue | 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 | error | DetectedIssue | 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 | error | DetectedIssue | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | DetectedIssue | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
This structure is derived from DetectedIssue
| Name | Flags | Card. | Type | Description & Constraints Filter: | ||||
|---|---|---|---|---|---|---|---|---|
| DetectedIssue |
0..* | DetectedIssue | Clinical issue with action | |||||
| id |
0..1 | id | Logical id of this artifact | |||||
| meta |
0..1 | Meta | Metadata about the resource | |||||
| implicitRules |
0..1 | uri | A set of rules under which this content was created | |||||
| language |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text |
0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
| contained |
0..* | Resource | Contained, inline Resources | |||||
| Slices for extension |
0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
| extension:pertinenceRating |
0..1 | integer | CPG Pertinence Rating Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-pertinenceRating | |||||
| extension:pertinentTo |
0..1 | Reference() | CPG Pertinent To Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-pertinentTo | |||||
| extension:instantiatesCaseFeature |
0..1 | canonical(CPG Case Feature Definition) | CPG Instantiates Case Feature Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-instantiatesCaseFeature | |||||
| extension:caseFeatureType |
0..1 | code | CPG Case Feature Type Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeatureType Binding: CPG Case Feature Type Value Set (required): Whether the case feature is asserted or inferred | |||||
| extension:caseFeaturePertinence |
0..1 | code | CPG Case Feature Pertinence Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeaturePertinence Binding: CPG Case Feature Pertinence Value Set (required): Describes the pertinence of a case feature | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored | |||||
| identifier |
0..* | Identifier | Unique id for the detected issue | |||||
| status |
1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Indicates the status of the identified issue. | |||||
| code |
1..1 | CodeableConcept | Issue 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 |
0..1 | code | high | moderate | low Binding: DetectedIssueSeverity (required): Indicates the potential degree of impact of the identified issue on the patient. | |||||
| patient |
0..1 | Reference(CPG Patient) | Associated patient | |||||
 identified[x] |
0..1 | When identified | ||||||
| identifiedDateTime |
dateTime | |||||||
| identifiedPeriod |
Period | |||||||
| author |
0..1 | Reference(Practitioner | PractitionerRole | Device) | The provider or device that identified the issue | |||||
| implicated |
0..* | Reference(Resource) | Problem resource | |||||
| evidence |
0..* | BackboneElement | Supporting evidence | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| code |
0..* | CodeableConcept | Manifestation Binding: ManifestationAndSymptomCodes (example): Codes that describes the types of evidence for a detected issue. | |||||
| detail |
0..* | Reference(Resource) | Supporting information | |||||
| detail |
0..1 | string | Description and context | |||||
| reference |
0..1 | uri | Authority for issue | |||||
| mitigation |
0..* | BackboneElement | Step taken to address | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| action |
1..1 | CodeableConcept | What 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..1 | dateTime | Date committed | |||||
| author |
0..1 | Reference(Practitioner | PractitionerRole) | Who is committing? | |||||
| Documentation for this format | ||||||||
| Path | Status | Usage | ValueSet | Version | Source |
| DetectedIssue.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std. |
| DetectedIssue.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std. |
| DetectedIssue.code | Base | preferred | Detected Issue Category | 📍4.0.1 | FHIR Std. |
| DetectedIssue.severity | Base | required | DetectedIssueSeverity | 📍4.0.1 | FHIR Std. |
| DetectedIssue.evidence.code | Base | example | Manifestation and Symptom Codes | 📍4.0.1 | FHIR Std. |
| DetectedIssue.mitigation.action | Base | preferred | Detected Issue Mitigation Action | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | DetectedIssue | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | DetectedIssue | 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 | error | DetectedIssue | 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 | error | DetectedIssue | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | DetectedIssue | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
This structure is derived from DetectedIssue
Summary
Mandatory: 1 element
Must-Support: 8 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| DetectedIssue |
0..* | DetectedIssue | Clinical issue with action | |
| implicitRules |
0..1 | uri | A set of rules under which this content was created | |
| Slices for extension |
0..* | Extension | Extension Slice: Unordered, Open by value:url | |
| extension:pertinenceRating |
0..1 | integer | CPG Pertinence Rating Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-pertinenceRating | |
| extension:pertinentTo |
0..1 | Reference() | CPG Pertinent To Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-pertinentTo | |
| extension:instantiatesCaseFeature |
0..1 | canonical(CPG Case Feature Definition) | CPG Instantiates Case Feature Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-instantiatesCaseFeature | |
| extension:caseFeatureType |
0..1 | code | CPG Case Feature Type Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeatureType Binding: CPG Case Feature Type Value Set (required): Whether the case feature is asserted or inferred | |
| extension:caseFeaturePertinence |
0..1 | code | CPG Case Feature Pertinence Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeaturePertinence Binding: CPG Case Feature Pertinence Value Set (required): Describes the pertinence of a case feature | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored | |
| status |
1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Indicates the status of the identified issue. | |
| code |
1..1 | CodeableConcept | Issue 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. | |
| patient |
0..1 | Reference(CPG Patient) | Associated patient | |
| evidence |
0..* | BackboneElement | Supporting evidence | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| code |
0..* | CodeableConcept | Manifestation Binding: ManifestationAndSymptomCodes (example): Codes that describes the types of evidence for a detected issue. | |
| detail |
0..* | Reference(Resource) | Supporting information | |
| Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| DetectedIssue.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std. |
| DetectedIssue.code | Base | preferred | Detected Issue Category | 📍4.0.1 | FHIR Std. |
| DetectedIssue.evidence.code | Base | example | Manifestation and Symptom Codes | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | DetectedIssue | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | DetectedIssue | 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 | error | DetectedIssue | 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 | error | DetectedIssue | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | DetectedIssue | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
Differential View
This structure is derived from DetectedIssue
Snapshot ViewView
| Name | Flags | Card. | Type | Description & Constraints Filter: | ||||
|---|---|---|---|---|---|---|---|---|
| DetectedIssue |
0..* | DetectedIssue | Clinical issue with action | |||||
| id |
0..1 | id | Logical id of this artifact | |||||
| meta |
0..1 | Meta | Metadata about the resource | |||||
| implicitRules |
0..1 | uri | A set of rules under which this content was created | |||||
| language |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text |
0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
| contained |
0..* | Resource | Contained, inline Resources | |||||
| Slices for extension |
0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
| extension:pertinenceRating |
0..1 | integer | CPG Pertinence Rating Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-pertinenceRating | |||||
| extension:pertinentTo |
0..1 | Reference() | CPG Pertinent To Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-pertinentTo | |||||
| extension:instantiatesCaseFeature |
0..1 | canonical(CPG Case Feature Definition) | CPG Instantiates Case Feature Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-instantiatesCaseFeature | |||||
| extension:caseFeatureType |
0..1 | code | CPG Case Feature Type Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeatureType Binding: CPG Case Feature Type Value Set (required): Whether the case feature is asserted or inferred | |||||
| extension:caseFeaturePertinence |
0..1 | code | CPG Case Feature Pertinence Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeaturePertinence Binding: CPG Case Feature Pertinence Value Set (required): Describes the pertinence of a case feature | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored | |||||
| identifier |
0..* | Identifier | Unique id for the detected issue | |||||
| status |
1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Indicates the status of the identified issue. | |||||
| code |
1..1 | CodeableConcept | Issue 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 |
0..1 | code | high | moderate | low Binding: DetectedIssueSeverity (required): Indicates the potential degree of impact of the identified issue on the patient. | |||||
| patient |
0..1 | Reference(CPG Patient) | Associated patient | |||||
| identified[x] |
0..1 | When identified | ||||||
| identifiedDateTime |
dateTime | |||||||
| identifiedPeriod |
Period | |||||||
| author |
0..1 | Reference(Practitioner | PractitionerRole | Device) | The provider or device that identified the issue | |||||
| implicated |
0..* | Reference(Resource) | Problem resource | |||||
| evidence |
0..* | BackboneElement | Supporting evidence | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| code |
0..* | CodeableConcept | Manifestation Binding: ManifestationAndSymptomCodes (example): Codes that describes the types of evidence for a detected issue. | |||||
| detail |
0..* | Reference(Resource) | Supporting information | |||||
| detail |
0..1 | string | Description and context | |||||
| reference |
0..1 | uri | Authority for issue | |||||
| mitigation |
0..* | BackboneElement | Step taken to address | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| action |
1..1 | CodeableConcept | What 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..1 | dateTime | Date committed | |||||
| author |
0..1 | Reference(Practitioner | PractitionerRole) | Who is committing? | |||||
| Documentation for this format | ||||||||
| Path | Status | Usage | ValueSet | Version | Source |
| DetectedIssue.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std. |
| DetectedIssue.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std. |
| DetectedIssue.code | Base | preferred | Detected Issue Category | 📍4.0.1 | FHIR Std. |
| DetectedIssue.severity | Base | required | DetectedIssueSeverity | 📍4.0.1 | FHIR Std. |
| DetectedIssue.evidence.code | Base | example | Manifestation and Symptom Codes | 📍4.0.1 | FHIR Std. |
| DetectedIssue.mitigation.action | Base | preferred | Detected Issue Mitigation Action | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | DetectedIssue | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | DetectedIssue | 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 | error | DetectedIssue | 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 | error | DetectedIssue | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | DetectedIssue | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
This structure is derived from DetectedIssue
Summary
Mandatory: 1 element
Must-Support: 8 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Other representations of profile: CSV, Excel, Schematron
IG © 2023+ HL7 International / Clinical Decision Support.
Package hl7.fhir.uv.cpg#3.0.0-ballot based on FHIR 4.0.1.
Generated
2026-11-10
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