HL7 FHIR Implementation Guide: Breast Cancer Data, Release 1 - US Realm (Draft for Comment 2)

SubstanceProfile

Definitions for cimi-entity-Substance.

1. Substance:cimi-entity-Substance
Definition

Any matter of defined composition that has discrete existence, whose origin may be biological, mineral or chemical.

Control0..*
InvariantsDefined on this element
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (: contained.text.empty())
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 (: contained.where(('#'+id in %resource.descendants().reference).not()).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())
2. Substance:cimi-entity-Substance.id
Definition

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

Control0..1
Typeid
Comments

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

3. Substance:cimi-entity-Substance.meta
Definition

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

Control0..1
TypeMeta
4. Substance:cimi-entity-Substance.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.

Control0..1
Typeuri
Is Modifiertrue
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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

5. Substance:cimi-entity-Substance.language
Definition

The base language in which the resource is written.

Control0..1
BindingA human language.
The codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable
Max Binding: All Languages
Typecode
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).

6. Substance:cimi-entity-Substance.text
Definition

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

Control0..1 This element is affected by the following invariants: dom-1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
Comments

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

7. Substance:cimi-entity-Substance.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

Control0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained 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.

8. Substance:cimi-entity-Substance.extension
Definition

May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

9. Substance:cimi-entity-Substance.extension:category
Definition

A class or division of people or things having particular shared characteristics

Control0..*
TypeExtension(CategoryExtension) (Extension Type: CodeableConcept)
10. Substance:cimi-entity-Substance.extension:category.id
Definition

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

Control0..1
Typestring
11. Substance:cimi-entity-Substance.extension:category.extension:extension
Definition

An Extension

Control0..0
TypeExtension
12. Substance:cimi-entity-Substance.extension:category.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-Category-extension
13. Substance:cimi-entity-Substance.extension:category.valueCodeableConcept
Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Control1..1
BindingThe codes SHALL be taken from Substance Category Codes; other codes may be used where these codes are not suitable
TypeCodeableConcept
14. Substance:cimi-entity-Substance.extension:activeflagasacodeableconcept
Definition

If the ActiveFlag is false, it indicates the record or item is no longer to be used and should generally be hidden for the user in the UI.

Control0..1
TypeExtension(ActiveFlagAsaCodeableConceptExtension) (Extension Type: CodeableConcept)
15. Substance:cimi-entity-Substance.extension:activeflagasacodeableconcept.id
Definition

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

Control0..1
Typestring
16. Substance:cimi-entity-Substance.extension:activeflagasacodeableconcept.extension:extension
Definition

An Extension

Control0..0
TypeExtension
17. Substance:cimi-entity-Substance.extension:activeflagasacodeableconcept.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-ActiveFlagAsaCodeableConcept-extension
18. Substance:cimi-entity-Substance.extension:activeflagasacodeableconcept.valueCodeableConcept
Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Control1..1
BindingThe codes SHALL be taken from FHIRSubstanceStatus
TypeCodeableConcept
19. Substance:cimi-entity-Substance.extension:details
Definition

A text note containing additional details, explanation, description, comment, or summarization. Details can discuss, support, explain changes to, or dispute information.

Control0..1
TypeExtension(DetailsExtension) (Extension Type: string)
20. Substance:cimi-entity-Substance.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. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content
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.

21. Substance:cimi-entity-Substance.identifier
Definition

Unique identifier for the substance.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Comments

This identifier is associated with the kind of substance in contrast to the Substance.instance.identifier which is associated with the package/container.

22. Substance:cimi-entity-Substance.status
Definition

A code to indicate if the substance is actively used.

Control0..1
BindingA code to indicate if the substance is actively used
The codes SHALL be taken from FHIRSubstanceStatus
Typecode
23. Substance:cimi-entity-Substance.category
Definition

A code that classifies the general type of substance. This is used for searching, sorting and display purposes.

Control0..*
BindingCategory or classification of substance
The codes SHALL be taken from Substance Category Codes; other codes may be used where these codes are not suitable
TypeCodeableConcept
Comments

The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in Substance.code.

24. Substance:cimi-entity-Substance.code
Definition

A code (or set of codes) that identify this substance.

Control1..1
BindingSubstance codes
The codes SHOULD be taken from Substance Code
TypeCodeableConcept
Comments

This could be a reference to an externally defined code. It could also be a locally assigned code (e.g. a formulary), optionally with translations to the standard drug codes.

25. Substance:cimi-entity-Substance.description
Definition

A description of the substance - its appearance, handling requirements, and other usage notes.

Control0..1
Typestring
26. Substance:cimi-entity-Substance.instance
Definition

Substance may be used to describe a kind of substance, or a specific package/container of the substance: an instance.

Control0..*
TypeBackboneElement
Meaning if MissingIf this element is not present, then the substance resource describes a kind of substance
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
27. Substance:cimi-entity-Substance.instance.id
Definition

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

Control0..1
Typestring
28. Substance:cimi-entity-Substance.instance.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

29. Substance:cimi-entity-Substance.instance.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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
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.

30. Substance:cimi-entity-Substance.instance.identifier
Definition

Identifier associated with the package/container (usually a label affixed directly).

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
TypeIdentifier
31. Substance:cimi-entity-Substance.instance.expiry
Definition

When the substance is no longer valid to use. For some substances, a single arbitrary date is used for expiry.

Control0..1
TypedateTime
32. Substance:cimi-entity-Substance.instance.quantity
Definition

The amount of the substance.

Control0..1
TypeQuantity(SimpleQuantity)
33. Substance:cimi-entity-Substance.ingredient
Definition

A substance can be composed of other substances.

Control0..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
34. Substance:cimi-entity-Substance.ingredient.id
Definition

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

Control0..1
Typestring
35. Substance:cimi-entity-Substance.ingredient.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

36. Substance:cimi-entity-Substance.ingredient.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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
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.

37. Substance:cimi-entity-Substance.ingredient.quantity
Definition

The amount of the ingredient in the substance - a concentration ratio.

Control0..1
TypeRatio(RatioProfile)
38. Substance:cimi-entity-Substance.ingredient.substance[x]
Definition

Another substance that is a component of this substance.

Control1..1
BindingSubstance Ingredient codes
For example codes, see Substance Code
TypeChoice of: CodeableConcept, Reference(SubstanceProfile)
[x] NoteSee Choice of Data Types for further information about how to use [x]