QI-Core Implementation Guide
8.0.0-ballot - STU 8 - ballot

QI-Core Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 8.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-qi-core/ and changes regularly. See the Directory of published versions

## Resource Profile: QICore Substance

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-substance | Version: 8.0.0-ballot
Standards status: Trial-use Active as of 2018-08-22 | Maturity Level: 4 | Computable Name: QICoreSubstance

Profile of Substance for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

"Must Have", "QI Elements" and "primary code path" are defined in the QI-Core Must Support section.
QI Elements:

- code: (QI) If this describes a specific package/container of the substance

Primary code path: code
(PCPath) This element is the primary code path for this resource CQL Retrieve
Usage

See the patterns page for implementation and usage patterns.

### Examples

Honey Bee venom (apitoxin) Example

Usages:

- Refer to this Profile: QICore AdverseEvent, QICore Medication and QICore Substance
- Examples for this Profile: Substance/example

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Substance |  | 0..* | Substance | A homogeneous material with a definite composition
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 0..1 | code | active | inactive | entered-in-error Binding: FHIRSubstanceStatus (required): A code to indicate if the substance is actively used.
code | Σ | 1..1 | CodeableConcept | (QI) If this describes a specific package/container of the substance Binding: SubstanceCode (preferred): Substance codes
instance | Σ | 0..* | BackboneElement | If this describes a specific package/container of the substance
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
quantity | Σ | 0..1 | SimpleQuantity(4.0.1) | (QI) Amount of substance in the package
ingredient | Σ | 0..* | BackboneElement | Composition information about the substance
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
quantity | Σ | 0..1 | Ratio | (QI) Optional amount (concentration)
substance[x] | Σ | 1..1 | Reference(QICore Substance) | (QI) A component of the substance
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Substance.status | Base | required | FHIRSubstanceStatus | 📍4.0.1 | FHIR Std.
Substance.code | Base | preferred | Substance Code | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Substance | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Substance | 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 | Substance | 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 | Substance | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Substance | 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()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Substance |  | 0..* | Substance | A homogeneous material with a definite composition
code |  | 1..1 | CodeableConcept | (QI) If this describes a specific package/container of the substance Binding: SubstanceCode (preferred): Substance codes
instance |  | 0..* | BackboneElement | If this describes a specific package/container of the substance
quantity |  | 0..1 | SimpleQuantity(4.0.1) | (QI) Amount of substance in the package
ingredient |  | 0..* | BackboneElement | Composition information about the substance
quantity |  | 0..1 | Ratio | (QI) Optional amount (concentration)
substance[x] |  | 1..1 | Reference(QICore Substance) | (QI) A component of the substance
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Substance.code | Base | preferred | Substance Code | 📦4.0.1 | FHIR Std.

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Substance |  | 0..* | Substance | A homogeneous material with a definite composition
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 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.
Additional Bindings | Purpose
AllLanguages | Max Binding
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
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Unique identifier
status | ?!Σ | 0..1 | code | active | inactive | entered-in-error Binding: FHIRSubstanceStatus (required): A code to indicate if the substance is actively used.
category | Σ | 0..* | CodeableConcept | What class/type of substance this is Binding: SubstanceCategoryCodes (extensible): Category or classification of substance.
code | Σ | 1..1 | CodeableConcept | (QI) If this describes a specific package/container of the substance Binding: SubstanceCode (preferred): Substance codes
description | Σ | 0..1 | string | Textual description of the substance, comments
instance | Σ | 0..* | BackboneElement | If this describes a specific package/container of the substance
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
identifier | Σ | 0..1 | Identifier | Identifier of the package/container
expiry | Σ | 0..1 | dateTime | When no longer valid to use
quantity | Σ | 0..1 | SimpleQuantity(4.0.1) | (QI) Amount of substance in the package
ingredient | Σ | 0..* | BackboneElement | Composition information about the substance
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
quantity | Σ | 0..1 | Ratio | (QI) Optional amount (concentration)
substance[x] | Σ | 1..1 | Reference(QICore Substance) | (QI) A component of the substance
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Substance.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Substance.status | Base | required | FHIRSubstanceStatus | 📍4.0.1 | FHIR Std.
Substance.category | Base | extensible | Substance Category Codes | 📍4.0.1 | FHIR Std.
Substance.code | Base | preferred | Substance Code | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Substance | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Substance | 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 | Substance | 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 | Substance | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Substance | 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()`

Summary

Structures

This structure refers to these other structures:

- QICore Substance (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-substance)

Maturity: 4

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Substance |  | 0..* | Substance | A homogeneous material with a definite composition
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 0..1 | code | active | inactive | entered-in-error Binding: FHIRSubstanceStatus (required): A code to indicate if the substance is actively used.
code | Σ | 1..1 | CodeableConcept | (QI) If this describes a specific package/container of the substance Binding: SubstanceCode (preferred): Substance codes
instance | Σ | 0..* | BackboneElement | If this describes a specific package/container of the substance
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
quantity | Σ | 0..1 | SimpleQuantity(4.0.1) | (QI) Amount of substance in the package
ingredient | Σ | 0..* | BackboneElement | Composition information about the substance
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
quantity | Σ | 0..1 | Ratio | (QI) Optional amount (concentration)
substance[x] | Σ | 1..1 | Reference(QICore Substance) | (QI) A component of the substance
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Substance.status | Base | required | FHIRSubstanceStatus | 📍4.0.1 | FHIR Std.
Substance.code | Base | preferred | Substance Code | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Substance | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Substance | 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 | Substance | 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 | Substance | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Substance | 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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Substance |  | 0..* | Substance | A homogeneous material with a definite composition
code |  | 1..1 | CodeableConcept | (QI) If this describes a specific package/container of the substance Binding: SubstanceCode (preferred): Substance codes
instance |  | 0..* | BackboneElement | If this describes a specific package/container of the substance
quantity |  | 0..1 | SimpleQuantity(4.0.1) | (QI) Amount of substance in the package
ingredient |  | 0..* | BackboneElement | Composition information about the substance
quantity |  | 0..1 | Ratio | (QI) Optional amount (concentration)
substance[x] |  | 1..1 | Reference(QICore Substance) | (QI) A component of the substance
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Substance.code | Base | preferred | Substance Code | 📦4.0.1 | FHIR Std.

Snapshot ViewView

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Substance |  | 0..* | Substance | A homogeneous material with a definite composition
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 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.
Additional Bindings | Purpose
AllLanguages | Max Binding
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
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Unique identifier
status | ?!Σ | 0..1 | code | active | inactive | entered-in-error Binding: FHIRSubstanceStatus (required): A code to indicate if the substance is actively used.
category | Σ | 0..* | CodeableConcept | What class/type of substance this is Binding: SubstanceCategoryCodes (extensible): Category or classification of substance.
code | Σ | 1..1 | CodeableConcept | (QI) If this describes a specific package/container of the substance Binding: SubstanceCode (preferred): Substance codes
description | Σ | 0..1 | string | Textual description of the substance, comments
instance | Σ | 0..* | BackboneElement | If this describes a specific package/container of the substance
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
identifier | Σ | 0..1 | Identifier | Identifier of the package/container
expiry | Σ | 0..1 | dateTime | When no longer valid to use
quantity | Σ | 0..1 | SimpleQuantity(4.0.1) | (QI) Amount of substance in the package
ingredient | Σ | 0..* | BackboneElement | Composition information about the substance
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
quantity | Σ | 0..1 | Ratio | (QI) Optional amount (concentration)
substance[x] | Σ | 1..1 | Reference(QICore Substance) | (QI) A component of the substance
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Substance.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Substance.status | Base | required | FHIRSubstanceStatus | 📍4.0.1 | FHIR Std.
Substance.category | Base | extensible | Substance Category Codes | 📍4.0.1 | FHIR Std.
Substance.code | Base | preferred | Substance Code | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Substance | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Substance | 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 | Substance | 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 | Substance | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Substance | 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()`

Summary

Structures

This structure refers to these other structures:

- QICore Substance (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-substance)

Maturity: 4

Other representations of profile: CSV, Excel, Schematron