Electronic Medicinal Product Information (ePI) FHIR Implementation Guide
1.0.0 - trial-use International flag

Electronic Medicinal Product Information (ePI) FHIR Implementation Guide, published by HL7 International - Biomedical Research & Regulation Work Group. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/emedicinal-product-info/ and changes regularly. See the Directory of published versions

Resource Profile: ClinicalUseDefinitionInteractionUvEpi - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 2

Definitions for the ClinicalUseDefinition-interaction-uv-epi resource profile.

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

0. ClinicalUseDefinition
2. ClinicalUseDefinition.identifier
ShortBusiness identifier for this clinical use.
NoteThis is a business identifier, not a resource identifier (see discussion)
4. ClinicalUseDefinition.type
Pattern Valueinteraction
6. ClinicalUseDefinition.subject
Control1..?
TypeReference(MedicinalProductDefinition (ePI))
8. ClinicalUseDefinition.status
ShortDefines whether this clinical use is draft, active or retired
10. ClinicalUseDefinition.contraindication
Control0..0
12. ClinicalUseDefinition.indication
Control0..0
14. ClinicalUseDefinition.interaction
16. ClinicalUseDefinition.interaction.interactant
18. ClinicalUseDefinition.interaction.interactant.item[x]
[x] NoteSee Choice of Data Types for further information about how to use [x]
SlicingThis element introduces a set of slices on ClinicalUseDefinition.interaction.interactant.item[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • type @ $this
  • 20. ClinicalUseDefinition.interaction.interactant.item[x]:itemCodeableConcept
    Slice NameitemCodeableConcept
    Control0..1
    BindingFor example codes, see Interactant
    (example to http://hl7.org/fhir/ValueSet/interactant)

    The specific substance that interacts. see additional bindings in JSON OR XML

    TypeCodeableConcept
    [x] NoteSee Choice of Data Types for further information about how to use [x]
    22. ClinicalUseDefinition.interaction.type
    ShortThe type of the interaction e.g. drug-drug, drug-food, drug-lab.
    24. ClinicalUseDefinition.undesirableEffect
    Control0..0
    26. ClinicalUseDefinition.warning
    Control0..0

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

    0. ClinicalUseDefinition
    Definition

    A single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure.

    ShortA single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure
    Control0..*
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantscud-1: Indication, Contraindication, Interaction, UndesirableEffect and Warning cannot be used in the same instance ((ClinicalUseDefinition.indication.count() + ClinicalUseDefinition.contraindication.count() + ClinicalUseDefinition.interaction.count() + ClinicalUseDefinition.undesirableEffect.count() + ClinicalUseDefinition.warning.count()) < 2)
    dom-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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(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())
    2. ClinicalUseDefinition.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 its 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 its meaning or interpretation
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    4. ClinicalUseDefinition.contained
    Definition

    These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

    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..*
    This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
    TypeResource
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Alternate Namesinline resources, anonymous resources, contained resources
    6. ClinicalUseDefinition.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 managable, 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
    Must Supportfalse
    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
    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())
    8. ClinicalUseDefinition.identifier
    Definition

    Business identifier for this issue.

    ShortBusiness identifier for this clinical use.Business identifier for this issue
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    TypeIdentifier
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    10. ClinicalUseDefinition.type
    Definition

    indication | contraindication | interaction | undesirable-effect | warning.

    Shortindication | contraindication | interaction | undesirable-effect | warning
    Control1..1
    BindingThe codes SHALL be taken from ClinicalUseDefinitionTypehttp://hl7.org/fhir/ValueSet/clinical-use-definition-type|5.0.0
    (required to http://hl7.org/fhir/ValueSet/clinical-use-definition-type|5.0.0)

    Overall defining type of this clinical use definition.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Pattern Valueinteraction
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. ClinicalUseDefinition.subject
    Definition

    The medication, product, substance, device, procedure etc. for which this is an indication.

    ShortThe medication, product, substance, device, procedure etc. for which this is an indication
    Control10..*
    TypeReference(MedicinalProductDefinition (ePI), MedicinalProductDefinition, Medication, ActivityDefinition, PlanDefinition, Device, DeviceDefinition, Substance, NutritionProduct, BiologicallyDerivedProduct)
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. ClinicalUseDefinition.status
    Definition

    Whether this is a current issue or one that has been retired etc.

    ShortDefines whether this clinical use is draft, active or retiredWhether this is a current issue or one that has been retired etc
    Control0..1
    BindingThe codes SHOULD be taken from PublicationStatushttp://hl7.org/fhir/ValueSet/publication-status
    (preferred to http://hl7.org/fhir/ValueSet/publication-status)

    The lifecycle status of an artifact.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. ClinicalUseDefinition.contraindication
    Definition

    Specifics for when this is a contraindication.

    ShortSpecifics for when this is a contraindication
    Control0..01
    This element is affected by the following invariants: cud-1
    TypeBackboneElement
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    19. ClinicalUseDefinition.indication
    Definition

    Specifics for when this is an indication.

    ShortSpecifics for when this is an indication
    Control0..01
    This element is affected by the following invariants: cud-1
    TypeBackboneElement
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. ClinicalUseDefinition.undesirableEffect
    Definition

    Describe the possible undesirable effects (negative outcomes) from the use of the medicinal product as treatment.

    ShortA possible negative outcome from the use of this treatment
    Control0..01
    This element is affected by the following invariants: cud-1
    TypeBackboneElement
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    25. ClinicalUseDefinition.warning
    Definition

    A critical piece of information about environmental, health or physical risks or hazards that serve as caution to the user. For example 'Do not operate heavy machinery', 'May cause drowsiness', or 'Get medical advice/attention if you feel unwell'.

    ShortCritical environmental, health or physical risks or hazards. For example 'Do not operate heavy machinery', 'May cause drowsiness'
    Control0..01
    This element is affected by the following invariants: cud-1
    TypeBackboneElement
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    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. ClinicalUseDefinition
    Definition

    A single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure.

    ShortA single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure
    Control0..*
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantscud-1: Indication, Contraindication, Interaction, UndesirableEffect and Warning cannot be used in the same instance ((ClinicalUseDefinition.indication.count() + ClinicalUseDefinition.contraindication.count() + ClinicalUseDefinition.interaction.count() + ClinicalUseDefinition.undesirableEffect.count() + ClinicalUseDefinition.warning.count()) < 2)
    dom-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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(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())
    2. ClinicalUseDefinition.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

    Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

    Control0..1
    Typeid
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    4. ClinicalUseDefinition.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
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    6. ClinicalUseDefinition.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 its 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 its meaning or interpretation
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    8. ClinicalUseDefinition.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 SHALL be taken from AllLanguages
    (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

    IETF language tag for a human language

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    10. ClinicalUseDefinition.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 a 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
    This element is affected by the following invariants: dom-6
    TypeNarrative
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Alternate Namesnarrative, html, xhtml, display
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. ClinicalUseDefinition.contained
    Definition

    These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

    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..*
    This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
    TypeResource
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Alternate Namesinline resources, anonymous resources, contained resources
    14. ClinicalUseDefinition.extension
    Definition

    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 managable, 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
    Must Supportfalse
    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())
    16. ClinicalUseDefinition.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 managable, 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
    Must Supportfalse
    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
    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. ClinicalUseDefinition.identifier
    Definition

    Business identifier for this issue.

    ShortBusiness identifier for this clinical use.
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    TypeIdentifier
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. ClinicalUseDefinition.type
    Definition

    indication | contraindication | interaction | undesirable-effect | warning.

    Shortindication | contraindication | interaction | undesirable-effect | warning
    Control1..1
    BindingThe codes SHALL be taken from ClinicalUseDefinitionType
    (required to http://hl7.org/fhir/ValueSet/clinical-use-definition-type|5.0.0)

    Overall defining type of this clinical use definition.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Pattern Valueinteraction
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. ClinicalUseDefinition.category
    Definition

    A categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy and Lactation", "Overdose", "Effects on Ability to Drive and Use Machines".

    ShortA categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy", "Overdose"
    Control0..*
    BindingThe codes SHOULD be taken from ClinicalUseDefinitionCategory
    (preferred to http://hl7.org/fhir/ValueSet/clinical-use-definition-category)

    A categorisation for a clinical use information item.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. ClinicalUseDefinition.subject
    Definition

    The medication, product, substance, device, procedure etc. for which this is an indication.

    ShortThe medication, product, substance, device, procedure etc. for which this is an indication
    Control1..*
    TypeReference(MedicinalProductDefinition (ePI))
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. ClinicalUseDefinition.status
    Definition

    Whether this is a current issue or one that has been retired etc.

    ShortDefines whether this clinical use is draft, active or retired
    Control0..1
    BindingThe codes SHOULD be taken from PublicationStatus
    (preferred to http://hl7.org/fhir/ValueSet/publication-status)

    The lifecycle status of an artifact.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. ClinicalUseDefinition.contraindication
    Definition

    Specifics for when this is a contraindication.

    ShortSpecifics for when this is a contraindication
    Control0..0
    This element is affected by the following invariants: cud-1
    TypeBackboneElement
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    44. ClinicalUseDefinition.indication
    Definition

    Specifics for when this is an indication.

    ShortSpecifics for when this is an indication
    Control0..0
    This element is affected by the following invariants: cud-1
    TypeBackboneElement
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    57. ClinicalUseDefinition.interaction
    Definition

    Specifics for when this is an interaction.

    ShortSpecifics for when this is an interaction
    Control0..1
    This element is affected by the following invariants: cud-1
    TypeBackboneElement
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    59. ClinicalUseDefinition.interaction.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
    This element is affected by the following invariants: ele-1
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    61. ClinicalUseDefinition.interaction.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 managable, 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())
    63. ClinicalUseDefinition.interaction.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 managable, 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())
    65. ClinicalUseDefinition.interaction.interactant
    Definition

    The specific medication, product, food, substance etc. or laboratory test that interacts.

    ShortThe specific medication, product, food etc. or laboratory test that interacts
    Control0..*
    TypeBackboneElement
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    67. ClinicalUseDefinition.interaction.interactant.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
    This element is affected by the following invariants: ele-1
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    69. ClinicalUseDefinition.interaction.interactant.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 managable, 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())
    71. ClinicalUseDefinition.interaction.interactant.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 managable, 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())
    73. ClinicalUseDefinition.interaction.interactant.item[x]
    Definition

    The specific medication, product, food, substance etc. or laboratory test that interacts.

    ShortThe specific medication, product, food etc. or laboratory test that interacts
    Control1..1
    BindingFor example codes, see Interactant
    (example to http://hl7.org/fhir/ValueSet/interactant)

    An interactant - a substance that may have a clinically significant effect on another.

    TypeChoice of: Reference(MedicinalProductDefinition, Medication, Substance, NutritionProduct, BiologicallyDerivedProduct, ObservationDefinition), CodeableConcept
    [x] NoteSee Choice of Data Types for further information about how to use [x]
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on ClinicalUseDefinition.interaction.interactant.item[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • type @ $this
    • 75. ClinicalUseDefinition.interaction.interactant.item[x]:itemCodeableConcept
      Slice NameitemCodeableConcept
      Definition

      The specific medication, product, food, substance etc. or laboratory test that interacts.

      ShortThe specific medication, product, food etc. or laboratory test that interacts
      Control0..1
      BindingFor example codes, see Interactant
      (example to http://hl7.org/fhir/ValueSet/interactant)

      The specific substance that interacts. see additional bindings in JSON OR XML

      TypeCodeableConcept
      [x] NoteSee Choice of Data Types for further information about how to use [x]
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      77. ClinicalUseDefinition.interaction.type
      Definition

      The type of the interaction e.g. drug-drug interaction, drug-food interaction, drug-lab test interaction.

      ShortThe type of the interaction e.g. drug-drug, drug-food, drug-lab.
      Control0..1
      BindingFor example codes, see InteractionType
      (example to http://hl7.org/fhir/ValueSet/interaction-type)

      A categorisation for an interaction between two substances.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      79. ClinicalUseDefinition.interaction.effect
      Definition

      The effect of the interaction, for example "reduced gastric absorption of primary medication".

      ShortThe effect of the interaction, for example "reduced gastric absorption of primary medication"
      Control0..1
      BindingFor example codes, see InteractionEffect
      (example to http://hl7.org/fhir/ValueSet/interaction-effect)

      A interaction effect of clinical use of a medication or other substance.

      TypeCodeableReference(ObservationDefinition)
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      81. ClinicalUseDefinition.interaction.incidence
      Definition

      The incidence of the interaction, e.g. theoretical, observed.

      ShortThe incidence of the interaction, e.g. theoretical, observed
      Control0..1
      BindingFor example codes, see InteractionIncidence
      (example to http://hl7.org/fhir/ValueSet/interaction-incidence)

      A categorisation for incidence of occurence of an interaction.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      83. ClinicalUseDefinition.interaction.management
      Definition

      Actions for managing the interaction.

      ShortActions for managing the interaction
      Control0..*
      BindingFor example codes, see InteractionManagement
      (example to http://hl7.org/fhir/ValueSet/interaction-management)

      A type of management for an interaction of a medication or other substance.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      85. ClinicalUseDefinition.population
      Definition

      The population group to which this applies.

      ShortThe population group to which this applies
      Control0..*
      TypeReference(Group)
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      87. ClinicalUseDefinition.library
      Definition

      Logic used by the clinical use definition.

      ShortLogic used by the clinical use definition
      Control0..*
      Typecanonical(Library)
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      89. ClinicalUseDefinition.undesirableEffect
      Definition

      Describe the possible undesirable effects (negative outcomes) from the use of the medicinal product as treatment.

      ShortA possible negative outcome from the use of this treatment
      Control0..0
      This element is affected by the following invariants: cud-1
      TypeBackboneElement
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      97. ClinicalUseDefinition.warning
      Definition

      A critical piece of information about environmental, health or physical risks or hazards that serve as caution to the user. For example 'Do not operate heavy machinery', 'May cause drowsiness', or 'Get medical advice/attention if you feel unwell'.

      ShortCritical environmental, health or physical risks or hazards. For example 'Do not operate heavy machinery', 'May cause drowsiness'
      Control0..0
      This element is affected by the following invariants: cud-1
      TypeBackboneElement
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))