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

ClinicalStatementModel


<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="cimi-statement-ClinicalStatement-model"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
  <p><b>BC ClinicalStatement Logical Model</b></p>
  <p>A special type of information entry consisting of a topic and a context.
The ClinicalStatement class provides the core pattern for more specific clinical statement classes, such as a statement that a finding has been found in a patient or that a procedure has been proposed by a clinical decision support system. The ClinicalStatement pattern defines the core attributes common to most clinical statements and specifies a composition pattern that encourage model component reuse and better alignment with the SNOMED CT Concept Model. A clinical statement is composed of the StatementTopic class (grouping of attributes for capturing information about a procedure or a clinical finding) and the StatementContext class (grouping of attributes providing the context for the statement topic such as whether a procedure was performed, requested, not performed or whether a finding is suspected present or absent in the patient). At the archetype level, the topic and context components are coordinated to form the clinical statement. For instance, the composition of the ProcedureTopic with the NotPerformed context indicates that the given procedure was not performed.</p>
</div>
  </text>
  <url
       value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-statement-ClinicalStatement-model"/>
  <identifier>
    <system value="http://hl7.org/fhir/us/breastcancer"/>
    <value value="cimi.statement.ClinicalStatement"/>
  </identifier>
  <version value="0.2.0"/>
  <name value="ClinicalStatementModel"/>
  <title value="BC ClinicalStatement Logical Model"/>
  <status value="draft"/>
  <date value="2018-08-17T00:00:00+00:00"/>
  <publisher
             value="The HL7 Cancer Interoperability Group sponsored by Clinical Interoperability Council Work Group (CIC)"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/cic/index.cfm"/>
    </telecom>
  </contact>
  <description
               value="A special type of information entry consisting of a topic and a context.
The ClinicalStatement class provides the core pattern for more specific clinical statement classes, such as a statement that a finding has been found in a patient or that a procedure has been proposed by a clinical decision support system. The ClinicalStatement pattern defines the core attributes common to most clinical statements and specifies a composition pattern that encourage model component reuse and better alignment with the SNOMED CT Concept Model. A clinical statement is composed of the StatementTopic class (grouping of attributes for capturing information about a procedure or a clinical finding) and the StatementContext class (grouping of attributes providing the context for the statement topic such as whether a procedure was performed, requested, not performed or whether a finding is suspected present or absent in the patient). At the archetype level, the topic and context components are coordinated to form the clinical statement. For instance, the composition of the ProcedureTopic with the NotPerformed context indicates that the given procedure was not performed."/>
  <kind value="logical"/>
  <abstract value="false"/>
  <type value="cimi-statement-ClinicalStatement-model"/>
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Element"/>
  <derivation value="specialization"/>
  <snapshot>
    <element id="cimi-statement-ClinicalStatement-model">
      <path value="cimi-statement-ClinicalStatement-model"/>
      <definition
                  value="A special type of information entry consisting of a topic and a context.
The ClinicalStatement class provides the core pattern for more specific clinical statement classes, such as a statement that a finding has been found in a patient or that a procedure has been proposed by a clinical decision support system. The ClinicalStatement pattern defines the core attributes common to most clinical statements and specifies a composition pattern that encourage model component reuse and better alignment with the SNOMED CT Concept Model. A clinical statement is composed of the StatementTopic class (grouping of attributes for capturing information about a procedure or a clinical finding) and the StatementContext class (grouping of attributes providing the context for the statement topic such as whether a procedure was performed, requested, not performed or whether a finding is suspected present or absent in the patient). At the archetype level, the topic and context components are coordinated to form the clinical statement. For instance, the composition of the ProcedureTopic with the NotPerformed context indicates that the given procedure was not performed."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="cimi-statement-ClinicalStatement-model"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="cimi-statement-ClinicalStatement-model.personOfRecord">
      <path value="cimi-statement-ClinicalStatement-model.personOfRecord"/>
      <short value="The person this entry belongs to."/>
      <definition value="The person this entry belongs to."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalStatement-model.personOfRecord"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-core-PersonOfRecord-model"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="cimi-statement-ClinicalStatement-model.statementTopic">
      <path value="cimi-statement-ClinicalStatement-model.statementTopic"/>
      <short
             value="Compositional and reusable grouping of clinical statement attributes that make up the clinical focus of a statement."/>
      <definition
                  value="Compositional and reusable grouping of clinical statement attributes that make up the clinical focus of a statement.

StatementTopic class attributes are aligned with SNOMED CT Concept Model attributes when such an overlap exists. Note that this class does not include contextual attributes such as the nature of the action (ordered, proposed, planned, etc...), the nature of the patient state being described (e.g., present, suspected present, absent), and the attribution of this information (the who, when, where, how, why of the information recorded)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalStatement-model.statementTopic"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-topic-StatementTopic-model"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="cimi-statement-ClinicalStatement-model.statementContext">
      <path value="cimi-statement-ClinicalStatement-model.statementContext"/>
      <short
             value="Compositional and reusable grouping of clinical statement attributes that provides the context for the topic of a clinical statement."/>
      <definition
                  value="Compositional and reusable grouping of clinical statement attributes that provides the context for the topic of a clinical statement.
The StatementContext class aligns with the SNOMED CT Situations with Explicit Context (SWEC) Concept Model. The StatementContext provides the expressivity required to specify that an act was performed or not performed or that a finding was asserted to be present or absent for the given subject of information. It also often holds provenance information relevant to the context of the clinical statement. It is important to note that by default the context applies to the conjunction of the attribute specified in the statement. For instance, if a clinical statement has a topic describing a rash on left arm and a context of &#39;absent&#39;, then the statement states that the subject of interest did not have a rash on the left arm but might have had one on the right arm."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalStatement-model.statementContext"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-context-StatementContext-model"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
  </snapshot>
  <differential>
    <element id="cimi-statement-ClinicalStatement-model">
      <path value="cimi-statement-ClinicalStatement-model"/>
      <definition
                  value="A special type of information entry consisting of a topic and a context.
The ClinicalStatement class provides the core pattern for more specific clinical statement classes, such as a statement that a finding has been found in a patient or that a procedure has been proposed by a clinical decision support system. The ClinicalStatement pattern defines the core attributes common to most clinical statements and specifies a composition pattern that encourage model component reuse and better alignment with the SNOMED CT Concept Model. A clinical statement is composed of the StatementTopic class (grouping of attributes for capturing information about a procedure or a clinical finding) and the StatementContext class (grouping of attributes providing the context for the statement topic such as whether a procedure was performed, requested, not performed or whether a finding is suspected present or absent in the patient). At the archetype level, the topic and context components are coordinated to form the clinical statement. For instance, the composition of the ProcedureTopic with the NotPerformed context indicates that the given procedure was not performed."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="cimi-statement-ClinicalStatement-model"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="cimi-statement-ClinicalStatement-model.personOfRecord">
      <path value="cimi-statement-ClinicalStatement-model.personOfRecord"/>
      <short value="The person this entry belongs to."/>
      <definition value="The person this entry belongs to."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalStatement-model.personOfRecord"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-core-PersonOfRecord-model"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="cimi-statement-ClinicalStatement-model.statementTopic">
      <path value="cimi-statement-ClinicalStatement-model.statementTopic"/>
      <short
             value="Compositional and reusable grouping of clinical statement attributes that make up the clinical focus of a statement."/>
      <definition
                  value="Compositional and reusable grouping of clinical statement attributes that make up the clinical focus of a statement.

StatementTopic class attributes are aligned with SNOMED CT Concept Model attributes when such an overlap exists. Note that this class does not include contextual attributes such as the nature of the action (ordered, proposed, planned, etc...), the nature of the patient state being described (e.g., present, suspected present, absent), and the attribution of this information (the who, when, where, how, why of the information recorded)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalStatement-model.statementTopic"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-topic-StatementTopic-model"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="cimi-statement-ClinicalStatement-model.statementContext">
      <path value="cimi-statement-ClinicalStatement-model.statementContext"/>
      <short
             value="Compositional and reusable grouping of clinical statement attributes that provides the context for the topic of a clinical statement."/>
      <definition
                  value="Compositional and reusable grouping of clinical statement attributes that provides the context for the topic of a clinical statement.
The StatementContext class aligns with the SNOMED CT Situations with Explicit Context (SWEC) Concept Model. The StatementContext provides the expressivity required to specify that an act was performed or not performed or that a finding was asserted to be present or absent for the given subject of information. It also often holds provenance information relevant to the context of the clinical statement. It is important to note that by default the context applies to the conjunction of the attribute specified in the statement. For instance, if a clinical statement has a topic describing a rash on left arm and a context of &#39;absent&#39;, then the statement states that the subject of interest did not have a rash on the left arm but might have had one on the right arm."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalStatement-model.statementContext"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-context-StatementContext-model"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
  </differential>
</StructureDefinition>