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8.17 Resource DeviceAssociation - Content

Orders and Observations icon

Work Group

Maturity Level: 0

Draft

Security Category: Patient

Compartments: Device, Patient, Practitioner

A record of association or dissociation of a device with a patient.

8.17.1 Scope and Usage

Device Association records the relationship between a device and a subject and/or operator. The scope covers all devices including, but not limited to: implantables (which previously was documented as the .association in the Device resource), wheelchairs, RTLS, personal health and point of care devices, diagnostic, imaging and durable medical equipment. This resource is intended to apply to any delivery environment and discipline where a device association is useful to record.

The subjects may include:

Patient - the following are often associated with a specific patient: implantables, prosthetics, activity trackers, mobility assistance, care monitoring, etc.
Group - some devices may be associated with a family group or treatment group. For example a weight scale or blood pressure cuff.
Practitioner - a device that is associated with the practitioner: pager, alert monitor, cell phone, laptop/tablet
Device - a device may be associated with another device when it is independent of the focal device. Note: this is different than the containment tree with parent element in the Device resource. For example a RFID tag used to track the location of a wheelchair.
RelatedPerson - a device that is associated with another person related to the patient. For example, an alerting device given to a spouse while their partner is in surgery.

8.17.2 Boundaries and Relationships

Device - This resource contains the association (incluuding history) between a device and a subject, eliminating the need for the Device resource to contain that history of associations which might allow unintended exposure of patient information.
DeviceUsage and Procedure - Both Procedure and DeviceUsage can comprehend association (not necessarily the related dissociation) of a device with a subject. They are intended to be used from the patient of process perspective.
- For tracking the act of implanting or using the device, Procedure may be used;
- For updating the patient's information about the usage of a device, DeviceUsage may be used;
- For tracking the different events along the lifecycle of the same Device, DeviceAssociation is appropriate

These are not exclusive, i.e. when associating a device with a patient, the it is possible to capture the patient's clinical information with a DeviceUsage resource, include the device in a Procedure for reporting, and keep the Device's traceability information with a DeviceAssociation resource.

To track changes in settings, Observation resource can be used, where Observation.subject references the Device that the settings apply to. If, e.g., the patient that the Device is associated with needs to be identified, then the DeviceAssociation where DeviceAssociation.period includes the Observation.effective[x] would have that patient in DeviceAssociation.subject.

8.17.3 References to this Resource

No references for this Resource.

8.17.4 Resource Content

Structure

Name	Flags	Card.	Type	Description & Constraints
DeviceAssociation	Σ D		DomainResource	A record of association or dissociation of a device with a patient Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier	Σ	0..*	Identifier	Instance identifier
device	Σ	1..1	Reference(Device)	Reference to the devices associated with the patient or group
relationship	Σ	0..*	CodeableConcept	Describes the relationship between the device and subject Binding: DeviceAssociation Relationship Codes (Extensible)
status	Σ	1..1	CodeableConcept	implanted \| explanted \| attached \| entered-in-error \| unknown Binding: DeviceAssociation Status Codes (Required)
statusReason	Σ	0..*	CodeableConcept	The reasons given for the current association status Binding: DeviceAssociation Status Reason Codes (Required)
subject	Σ	0..1	Reference(Patient \| Group \| Organization \| Practitioner \| PractitionerRole \| RelatedPerson \| Device)	The individual, group of individuals or device that the device is on or associated with
bodyStructure	Σ	0..1	Reference(BodyStructure)	Current anatomical location of the device in/on subject
period	Σ	0..1	Period	Begin and end dates and times for the device association
operation	Σ	0..*	BackboneElement	The details about the device when it is in use to describe its operation
status	Σ	1..1	CodeableConcept	Device operational condition Binding: FHIR Device Association Operation Status (Example)
operator	Σ	0..*	Reference(Patient \| Practitioner \| RelatedPerson)	The individual performing the action enabled by the device
period	Σ	0..1	Period	Begin and end dates and times for the device's operation
Documentation for this format

See the Extensions for this resource

XML Template

<DeviceAssociation xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Instance identifier --></identifier>
 <device><!-- 1..1 Reference(Device) Reference to the devices associated with the patient or group --></device>
 <relationship><!-- 0..* CodeableConcept Describes the relationship between the device and subject --></relationship>
 <status><!-- 1..1 CodeableConcept implanted | explanted | attached | entered-in-error | unknown --></status>
 <statusReason><!-- 0..* CodeableConcept The reasons given for the current association status --></statusReason>
 <subject><!-- 0..1 Reference(Device|Group|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) The individual, group of individuals or device that the device is on or associated with --></subject>
 <bodyStructure><!-- 0..1 Reference(BodyStructure) Current anatomical location of the device in/on subject --></bodyStructure>
 <period><!-- 0..1 Period Begin and end dates and times for the device association --></period>
 <operation>  <!-- 0..* The details about the device when it is in use to describe its operation -->
  <status><!-- 1..1 CodeableConcept Device operational condition --></status>
  <operator><!-- 0..* Reference(Patient|Practitioner|RelatedPerson) The individual performing the action enabled by the device --></operator>
  <period><!-- 0..1 Period Begin and end dates and times for the device's operation --></period>
 </operation>
</DeviceAssociation>

JSON Template

{
  "resourceType" : "DeviceAssociation",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Instance identifier
  "device" : { Reference(Device) }, // R!  Reference to the devices associated with the patient or group
  "relationship" : [{ CodeableConcept }], // Describes the relationship between the device and subject
  "status" : { CodeableConcept }, // R!  implanted | explanted | attached | entered-in-error | unknown
  "statusReason" : [{ CodeableConcept }], // The reasons given for the current association status
  "subject" : { Reference(Device|Group|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }, // The individual, group of individuals or device that the device is on or associated with
  "bodyStructure" : { Reference(BodyStructure) }, // Current anatomical location of the device in/on subject
  "period" : { Period }, // Begin and end dates and times for the device association
  "operation" : [{ // The details about the device when it is in use to describe its operation
    "status" : { CodeableConcept }, // R!  Device operational condition
    "operator" : [{ Reference(Patient|Practitioner|RelatedPerson) }], // The individual performing the action enabled by the device
    "period" : { Period } // Begin and end dates and times for the device's operation
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:DeviceAssociation;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Instance identifier
  fhir:device [ Reference(Device) ] ; # 1..1 Reference to the devices associated with the patient or group
  fhir:relationship  ( [ CodeableConcept ] ... ) ; # 0..* Describes the relationship between the device and subject
  fhir:status [ CodeableConcept ] ; # 1..1 implanted | explanted | attached | entered-in-error | unknown
  fhir:statusReason  ( [ CodeableConcept ] ... ) ; # 0..* The reasons given for the current association status
  fhir:subject [ Reference(Device|Group|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 The individual, group of individuals or device that the device is on or associated with
  fhir:bodyStructure [ Reference(BodyStructure) ] ; # 0..1 Current anatomical location of the device in/on subject
  fhir:period [ Period ] ; # 0..1 Begin and end dates and times for the device association
  fhir:operation ( [ # 0..* The details about the device when it is in use to describe its operation
    fhir:status [ CodeableConcept ] ; # 1..1 Device operational condition
    fhir:operator  ( [ Reference(Patient|Practitioner|RelatedPerson) ] ... ) ; # 0..* The individual performing the action enabled by the device
    fhir:period [ Period ] ; # 0..1 Begin and end dates and times for the device's operation
  ] ... ) ;
]

Structure

Name	Flags	Card.	Type	Description & Constraints
DeviceAssociation	Σ D		DomainResource	A record of association or dissociation of a device with a patient Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier	Σ	0..*	Identifier	Instance identifier
device	Σ	1..1	Reference(Device)	Reference to the devices associated with the patient or group
relationship	Σ	0..*	CodeableConcept	Describes the relationship between the device and subject Binding: DeviceAssociation Relationship Codes (Extensible)
status	Σ	1..1	CodeableConcept	implanted \| explanted \| attached \| entered-in-error \| unknown Binding: DeviceAssociation Status Codes (Required)
statusReason	Σ	0..*	CodeableConcept	The reasons given for the current association status Binding: DeviceAssociation Status Reason Codes (Required)
subject	Σ	0..1	Reference(Patient \| Group \| Organization \| Practitioner \| PractitionerRole \| RelatedPerson \| Device)	The individual, group of individuals or device that the device is on or associated with
bodyStructure	Σ	0..1	Reference(BodyStructure)	Current anatomical location of the device in/on subject
period	Σ	0..1	Period	Begin and end dates and times for the device association
operation	Σ	0..*	BackboneElement	The details about the device when it is in use to describe its operation
status	Σ	1..1	CodeableConcept	Device operational condition Binding: FHIR Device Association Operation Status (Example)
operator	Σ	0..*	Reference(Patient \| Practitioner \| RelatedPerson)	The individual performing the action enabled by the device
period	Σ	0..1	Period	Begin and end dates and times for the device's operation
Documentation for this format

See the Extensions for this resource

UML Diagram (Legend)

XML Template

<DeviceAssociation xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Instance identifier --></identifier>
 <device><!-- 1..1 Reference(Device) Reference to the devices associated with the patient or group --></device>
 <relationship><!-- 0..* CodeableConcept Describes the relationship between the device and subject --></relationship>
 <status><!-- 1..1 CodeableConcept implanted | explanted | attached | entered-in-error | unknown --></status>
 <statusReason><!-- 0..* CodeableConcept The reasons given for the current association status --></statusReason>
 <subject><!-- 0..1 Reference(Device|Group|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) The individual, group of individuals or device that the device is on or associated with --></subject>
 <bodyStructure><!-- 0..1 Reference(BodyStructure) Current anatomical location of the device in/on subject --></bodyStructure>
 <period><!-- 0..1 Period Begin and end dates and times for the device association --></period>
 <operation>  <!-- 0..* The details about the device when it is in use to describe its operation -->
  <status><!-- 1..1 CodeableConcept Device operational condition --></status>
  <operator><!-- 0..* Reference(Patient|Practitioner|RelatedPerson) The individual performing the action enabled by the device --></operator>
  <period><!-- 0..1 Period Begin and end dates and times for the device's operation --></period>
 </operation>
</DeviceAssociation>

JSON Template

{
  "resourceType" : "DeviceAssociation",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Instance identifier
  "device" : { Reference(Device) }, // R!  Reference to the devices associated with the patient or group
  "relationship" : [{ CodeableConcept }], // Describes the relationship between the device and subject
  "status" : { CodeableConcept }, // R!  implanted | explanted | attached | entered-in-error | unknown
  "statusReason" : [{ CodeableConcept }], // The reasons given for the current association status
  "subject" : { Reference(Device|Group|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }, // The individual, group of individuals or device that the device is on or associated with
  "bodyStructure" : { Reference(BodyStructure) }, // Current anatomical location of the device in/on subject
  "period" : { Period }, // Begin and end dates and times for the device association
  "operation" : [{ // The details about the device when it is in use to describe its operation
    "status" : { CodeableConcept }, // R!  Device operational condition
    "operator" : [{ Reference(Patient|Practitioner|RelatedPerson) }], // The individual performing the action enabled by the device
    "period" : { Period } // Begin and end dates and times for the device's operation
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:DeviceAssociation;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Instance identifier
  fhir:device [ Reference(Device) ] ; # 1..1 Reference to the devices associated with the patient or group
  fhir:relationship  ( [ CodeableConcept ] ... ) ; # 0..* Describes the relationship between the device and subject
  fhir:status [ CodeableConcept ] ; # 1..1 implanted | explanted | attached | entered-in-error | unknown
  fhir:statusReason  ( [ CodeableConcept ] ... ) ; # 0..* The reasons given for the current association status
  fhir:subject [ Reference(Device|Group|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 The individual, group of individuals or device that the device is on or associated with
  fhir:bodyStructure [ Reference(BodyStructure) ] ; # 0..1 Current anatomical location of the device in/on subject
  fhir:period [ Period ] ; # 0..1 Begin and end dates and times for the device association
  fhir:operation ( [ # 0..* The details about the device when it is in use to describe its operation
    fhir:status [ CodeableConcept ] ; # 1..1 Device operational condition
    fhir:operator  ( [ Reference(Patient|Practitioner|RelatedPerson) ] ... ) ; # 0..* The individual performing the action enabled by the device
    fhir:period [ Period ] ; # 0..1 Begin and end dates and times for the device's operation
  ] ... ) ;
]

Changes from both R4 and R4B

This resource did not exist in Release R4

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

Additional definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis

8.17.4.1 Terminology Bindings

Path	ValueSet	Type	Documentation
DeviceAssociation.relationship	DeviceAssociationCodes (a valid code from DeviceAssociation Relationship Codes)	Extensible	DeviceAssociation Relationship Codes
DeviceAssociation.status	DeviceAssociationCodes (a valid code from DeviceAssociation Status Codes)	Required	DeviceAssociation Status Codes
DeviceAssociation.statusReason	DeviceAssociationCodes (a valid code from DeviceAssociation Status Reason Codes)	Required	DeviceAssociation Status Reason Codes
DeviceAssociation.operation.status	FHIRDeviceAssociationOperationStatus	Example	The status for the device association operation.

Path

ValueSet

Type

Documentation

DeviceAssociation.relationship

DeviceAssociationCodes (a valid code from DeviceAssociation Relationship Codes)

Extensible

DeviceAssociation Relationship Codes

DeviceAssociation.status

DeviceAssociationCodes (a valid code from DeviceAssociation Status Codes)

Required

DeviceAssociation Status Codes

DeviceAssociation.statusReason

DeviceAssociationCodes (a valid code from DeviceAssociation Status Reason Codes)

Required

DeviceAssociation Status Reason Codes

DeviceAssociation.operation.status

FHIRDeviceAssociationOperationStatus

Example

The status for the device association operation.

8.17.5 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource, and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name	Type	Description	Expression	In Common
date TU	date	Search for associations at or within specific times	DeviceAssociation.period
device TU	reference	Search for products that match this code	DeviceAssociation.device (Device)
identifier TU	token	The identifier of the device association	DeviceAssociation.identifier
operator TU	reference	The identity of a operator for whom to list associations	DeviceAssociation.operation.operator (Practitioner, Patient, RelatedPerson)
relationship TU	token	Search for specific device association relationships	DeviceAssociation.relationship
status TU	token	The status of the device associations	DeviceAssociation.status
subject TU	reference	The identity of a patient for whom to list associations	DeviceAssociation.subject (Practitioner, Group, Organization, Device, Patient, PractitionerRole, RelatedPerson)