FHIR CI-Build

This is the Continuous Integration Build of FHIR (will be incorrect/inconsistent at times).
See the Directory of published versions

Example StructureDefinition/DetectedIssue (XML)

Clinical Decision Support Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Device, Patient, Practitioner

Raw XML (canonical form + also see XML Format Specification)

Jump past Narrative

StructureDefinition for detectedissue

<?xml version="1.0" encoding="UTF-8"?>

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="DetectedIssue"/> 
  <meta> 
    <lastUpdated value="2024-02-21T22:27:56.880+00:00"/> 
  </meta> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">
      <table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align:
       top;">
        <tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align:
         top">
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="The logical name of the element">Name</a> 
          </th> 
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Information about the use of the element">Flags</a> 
          </th> 
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a> 
          </th> 
          <th class="hierarchy" style="width: 100px">
            <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Reference to the type of the element">Type</a> 
          </th> 
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Additional information about the element">Description &amp; Constraints</a> 
            <span style="float: right">
              <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format">
                <img alt="doco" src="data:(snipped in html view)" style="background-color: inherit"/> 
              </a> 
            </span> 
          </th> 
        </tr> 
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAJUlEQVR4Xu3IIQEAAAgDsHd9/w4EQIOamFnaBgAA4M
          MKAACAKwNp30CqZFfFmwAAAABJRU5ErkJggg==)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Resource"/>  
            <span title="DetectedIssue : Indicates an actual or potential clinical issue with or between
             one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction,
             Ineffective treatment frequency, Procedure-condition conflict, gaps in care, etc.">DetectedIssue</span> 
            <a name="DetectedIssue"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="versions.html#std-process" style="padding-left: 3px; padding-right: 3px; border: 1px grey solid; font-weight: bold;
             color: black; background-color: #fff5e6" title="Standards Status = Trial Use">TU</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="domainresource.html">DomainResource</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Clinical issue with action
            <br/>  
            <br/>  Elements defined in Ancestors: 
            <a href="resource.html#Resource" title="The logical id of the resource, as used in the URL for the resource. Once assigned,
             this value never changes.">id</a> , 
            <a href="resource.html#Resource" title="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.">meta</a> , 
            <a href="resource.html#Resource" title="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.">implicitRules</a> , 
            <a href="resource.html#Resource" title="The base language in which the resource is written.">language</a> , 
            <a href="domainresource.html#DomainResource" title="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
             &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions
             may define what content should be represented in the narrative to ensure clinical
             safety.">text</a> , 
            <a href="domainresource.html#DomainResource" title="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.">contained</a> , 
            <a href="domainresource.html#DomainResource" title="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.">extension</a> , 
            <a href="domainresource.html#DomainResource" title="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).">modifierExtension</a> 
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
          EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Data Type"/>  
            <span title="DetectedIssue.identifier : Business identifier associated with the detected issue
             record.">identifier</span> 
            <a name="DetectedIssue.identifier"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#Identifier">Identifier</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Unique id for the detected issue
            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Primitive Data Type"/>  
            <span title="DetectedIssue.status : Indicates the status of the detected issue.">status</span> 
            <a name="DetectedIssue.status"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="conformance-rules.html#isModifier" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is a modifier element">?!</a> 
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">1..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#code">code</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">preliminary | final | entered-in-error | mitigated
            <br/>  Binding: 
            <a href="valueset-detectedissue-status.html">Detected Issue Status</a>  (
            <a href="terminologies.html#required" title="To be conformant, the concept in this element SHALL be from the specified value
             set.">Required</a> )
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
          EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Data Type"/>  
            <span title="DetectedIssue.category : A code that classifies the general type of detected issue.">category</span> 
            <a name="DetectedIssue.category"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Type of detected issue, e.g. drug-drug, duplicate therapy, etc
            <br/>  Binding: 
            <a href="valueset-detectedissue-category.html">Detected Issue Category</a>  (
            <a href="terminologies.html#preferred" title="Instances are encouraged to draw from the specified codes for interoperability
             purposes but are not required to do so to be considered conformant.">Preferred</a> )
            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Data Type"/>  
            <span title="DetectedIssue.code : Identifies the specific type of issue identified.">code</span> 
            <a name="DetectedIssue.code"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Specific type of detected issue, e.g. drug-drug, duplicate therapy, etc
            <br/>  Binding: 
            <a href="valueset-detectedissue-category.html">Detected Issue Category</a>  (
            <a href="terminologies.html#preferred" title="Instances are encouraged to draw from the specified codes for interoperability
             purposes but are not required to do so to be considered conformant.">Preferred</a> )
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
          EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type"/>  
            <span title="DetectedIssue.severity : Indicates the degree of importance associated with the
             identified issue based on the potential impact on the patient.">severity</span> 
            <a name="DetectedIssue.severity"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#code">code</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">high | moderate | low
            <br/>  Binding: 
            <a href="valueset-detectedissue-severity.html">Detected Issue Severity</a>  (
            <a href="terminologies.html#required" title="To be conformant, the concept in this element SHALL be from the specified value
             set.">Required</a> )
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  
            <span title="DetectedIssue.subject : Indicates the subject whose record the detected issue is
             associated with.">subject</span> 
            <a name="DetectedIssue.subject"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="patient.html">Patient</a>  | 
            <a href="group.html">Group</a>  | 
            <a href="device.html">Device</a>  | 
            <a href="location.html">Location</a>  | 
            <a href="organization.html">Organization</a>  | 
            <a href="procedure.html">Procedure</a>  | 
            <a href="practitioner.html">Practitioner</a>  | 
            <a href="medication.html">Medication</a>  | 
            <a href="substance.html">Substance</a>  | 
            <a href="biologicallyderivedproduct.html">BiologicallyDerivedProduct</a>  | 
            <a href="nutritionproduct.html">NutritionProduct</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Associated subject
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
          EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource"/>  
            <span title="DetectedIssue.encounter : The encounter during which this issue was detected.">encounter</span> 
            <a name="DetectedIssue.encounter"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="encounter.html">Encounter</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Encounter detected issue is part of
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Choice of Types"/>  
            <span title="DetectedIssue.identified[x] : The date or period when the detected issue was initially
             identified.">identified[x]</span> 
            <a name="DetectedIssue.identified_x_"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">When identified
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAMUlEQVR4Xu3LMQoAIBA
          Dwftr/v8GtdbqEAthAtMspJJUx9rYW8ftHwAA+NcRAAAAXplLq0BWj/rZigAAAABJRU5ErkJggg==)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type"/>  
            <span title="A date, date-time or partial date (e.g. just year or year + month).  If hours and
             minutes are specified, a UTC offset SHALL be populated. The format is a union of
             the schema types gYear, gYearMonth, date and dateTime. Seconds must be provided
             due to schema type constraints but may be zero-filled and may be ignored.     
                        Dates SHALL be valid dates.">identifiedDateTime</span> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#dateTime">dateTime</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Data Type"/>  
            <span title="A time period defined by a start and end date and optionally time.">identifiedPeriod</span> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#Period">Period</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
          EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource"/>  
            <span title="DetectedIssue.author : Individual or device responsible for the issue being raised.
              For example, a decision support application or a pharmacist conducting a medication
             review.">author</span> 
            <a name="DetectedIssue.author"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="patient.html">Patient</a>  | 
            <a href="relatedperson.html">RelatedPerson</a>  | 
            <a href="practitioner.html">Practitioner</a>  | 
            <a href="practitionerrole.html">PractitionerRole</a>  | 
            <a href="device.html">Device</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">The provider or device that identified the issue
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  
            <span title="DetectedIssue.implicated : Indicates the resource representing the current activity
             or proposed activity that is potentially problematic.">implicated</span> 
            <a name="DetectedIssue.implicated"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="resourcelist.html">Any</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Problem resource
            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
          EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Element"/>  
            <span title="DetectedIssue.evidence : Supporting evidence or manifestations that provide the
             basis for identifying the detected issue such as a GuidanceResponse or MeasureReport.">evidence</span> 
            <a name="DetectedIssue.evidence"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="types.html#BackBoneElement">BackboneElement</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Supporting evidence
            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAMUlEQVR4Xu3LMQoAIBADwftr/v8GtdbqEAthAtMspJ
          JUx9rYW8ftHwAA+NcRAAAAXplLq0BWj/rZigAAAABJRU5ErkJggg==)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Data Type"/>  
            <span title="DetectedIssue.evidence.code : A manifestation that led to the recording of this
             detected issue.">code</span> 
            <a name="DetectedIssue.evidence.code"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Manifestation
            <br/>  Binding: 
            <a href="valueset-manifestation-or-symptom.html">Manifestation and Symptom Codes</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value
             set.  The value set merely provides examples of the types of concepts intended
             to be included.">Example</a> )
            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
          EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource"/>  
            <span title="DetectedIssue.evidence.detail : Links to resources that constitute evidence for
             the detected issue such as a GuidanceResponse or MeasureReport.">detail</span> 
            <a name="DetectedIssue.evidence.detail"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="resourcelist.html">Any</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Supporting information
            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Primitive Data Type"/>  
            <span title="DetectedIssue.detail : A textual explanation of the detected issue.">detail</span> 
            <a name="DetectedIssue.detail"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#markdown">markdown</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Description and context
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
          EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type"/>  
            <span title="DetectedIssue.reference : The literature, knowledge-base or similar reference that
             describes the propensity for the detected issue identified.">reference</span> 
            <a name="DetectedIssue.reference"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#uri">uri</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Authority for issue
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAJUlEQVR4Xu3IIQEAAAgDsHd9/w4EQIOamFnaBgAA4M
          MKAACAKwNp30CqZFfFmwAAAABJRU5ErkJggg==)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Element"/>  
            <span title="DetectedIssue.mitigation : Indicates an action that has been taken or is committed
             to reduce or eliminate the likelihood of the risk identified by the detected issue
             from manifesting.  Can also reflect an observation of known mitigating factors
             that may reduce/eliminate the need for any action.">mitigation</span> 
            <a name="DetectedIssue.mitigation"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="types.html#BackBoneElement">BackboneElement</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Step taken to address
            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALElEQVR4Xu3IsQ0AIAw
          Esez6+89AqKGGJj7JzVWS+mm3zgcAAMxwDQAAgFcaYAVAgNGLTjgAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Data Type"/>  
            <span title="DetectedIssue.mitigation.action : Describes the action that was taken or the observation
             that was made that reduces/eliminates the risk associated with the identified issue.">action</span> 
            <a name="DetectedIssue.mitigation.action"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">1..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">What mitigation?
            <br/>  Binding: 
            <a href="valueset-detectedissue-mitigation-action.html">Detected Issue Mitigation Action</a>  (
            <a href="terminologies.html#preferred" title="Instances are encouraged to draw from the specified codes for interoperability
             purposes but are not required to do so to be considered conformant.">Preferred</a> )
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALElEQVR4Xu3IsQ0AIAwEsez6+89AqKGGJj7JzVWS+m
          m3zgcAAMxwDQAAgFcaYAVAgNGLTjgAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Primitive Data Type"/>  
            <span title="DetectedIssue.mitigation.date : Indicates when the mitigating action was documented.">date</span> 
            <a name="DetectedIssue.mitigation.date"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#dateTime">dateTime</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Date committed
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALElEQVR4Xu3IsQ0AIAw
          Esez6+89AqKGGJj7JzVWS+mm3zgcAAMxwDQAAgFcaYAVAgNGLTjgAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource"/>  
            <span title="DetectedIssue.mitigation.author : Identifies the practitioner who determined the
             mitigation and takes responsibility for the mitigation step occurring.">author</span> 
            <a name="DetectedIssue.mitigation.author"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="practitioner.html">Practitioner</a>  | 
            <a href="practitionerrole.html">PractitionerRole</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Who is committing?
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAJUlEQVR4Xu3IIQEAAAgDsHd9/w4EQIOamFnaBgAA4M
          MKAACAKwNp30CqZFfFmwAAAABJRU5ErkJggg==)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Data Type"/>  
            <span title="DetectedIssue.mitigation.note : Clinicians may add additional notes or justifications
             about the mitigation action. For example, patient can have this drug because they
             have had it before without any issues. Multiple justifications may be provided.">note</span> 
            <a name="DetectedIssue.mitigation.note"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#Annotation">Annotation</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Additional notes about the mitigation
            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr> 
          <td class="hierarchy" colspan="5">
            <br/>  
            <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format">
              <img alt="doco" src="data:(snipped in html view)" style="background-color: inherit"/>  Documentation for this format
            </a> 
          </td> 
        </tr> 
      </table> 
    </div> 
  </text> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="trial-use"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="cds"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="2"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category">
    <valueCode value="patient"/> 
  </extension> 
  <url value="http://hl7.org/fhir/StructureDefinition/DetectedIssue"/> 
  <version value="6.0.0-cibuild"/> 
  <name value="DetectedIssue"/> 
  <status value="draft"/> 
  <experimental value="false"/> 
  <date value="2024-02-21T22:27:56+00:00"/> 
  <publisher value="HL7 International / Clinical Decision Support"/> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="http://www.hl7.org/Special/committees/fiwg"/> 
    </telecom> 
  </contact> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="http://www.hl7.org/Special/committees/dss"/> 
    </telecom> 
  </contact> 
  <description value="Indicates an actual or potential clinical issue with or between one or more active
   or proposed clinical actions for a patient; e.g. Drug-drug interaction, Ineffective
   treatment frequency, Procedure-condition conflict, gaps in care, etc."/> 
  <jurisdiction> 
    <coding> 
      <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/> 
      <code value="001"/> 
      <display value="World"/> 
    </coding> 
  </jurisdiction> 
  <fhirVersion value="6.0.0-cibuild"/> 
  <mapping> 
    <identity value="workflow"/> 
    <uri value="http://hl7.org/fhir/workflow"/> 
    <name value="Workflow Pattern"/> 
  </mapping> 
  <mapping> 
    <identity value="w5"/> 
    <uri value="http://hl7.org/fhir/fivews"/> 
    <name value="FiveWs Pattern Mapping"/> 
  </mapping> 
  <mapping> 
    <identity value="v2"/> 
    <uri value="http://hl7.org/v2"/> 
    <name value="HL7 V2 Mapping"/> 
  </mapping> 
  <mapping> 
    <identity value="rim"/> 
    <uri value="http://hl7.org/v3"/> 
    <name value="RIM Mapping"/> 
  </mapping> 
  <kind value="resource"/> 
  <abstract value="false"/> 
  <type value="DetectedIssue"/> 
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
  <derivation value="specialization"/> 
  <snapshot> 
    <element id="DetectedIssue">
      <path value="DetectedIssue"/> 
      <short value="Clinical issue with action"/> 
      <definition value="Indicates an actual or potential clinical issue with or between one or more active
       or proposed clinical actions for a patient; e.g. Drug-drug interaction, Ineffective
       treatment frequency, Procedure-condition conflict, gaps in care, etc."/> 
      <alias value="DDI"/> 
      <alias value="drug-drug interaction"/> 
      <alias value="Contraindication"/> 
      <alias value="Alert"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DetectedIssue"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <constraint> 
        <key value="dom-2"/> 
        <severity value="error"/> 
        <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/> 
        <expression value="contained.contained.empty()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-3"/> 
        <severity value="error"/> 
        <human value="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"/> 
        <expression value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofTy
        pe(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('unmat
        ched', id).empty()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-4"/> 
        <severity value="error"/> 
        <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId
         or a meta.lastUpdated"/> 
        <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-5"/> 
        <severity value="error"/> 
        <human value="If a resource is contained in another resource, it SHALL NOT have a security label"/> 
        <expression value="contained.meta.security.empty()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
          <valueBoolean value="true"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
          <valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can
           display the resource to a human safely. Including a human readable representation
           in the resource makes for a much more robust eco-system and cheaper handling of
           resources by intermediary systems. Some ecosystems restrict distribution of resources
           to only those systems that do fully understand the resources, and as a consequence
           implementers may believe that the narrative is superfluous. However experience
           shows that such eco-systems often open up to new participants over time."/> 
        </extension> 
        <key value="dom-6"/> 
        <severity value="warning"/> 
        <human value="A resource should have narrative for robust management"/> 
        <expression value="text.`div`.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Entity, Role, or Act,Observation[classCode=ALRT, moodCode=EVN)"/> 
      </mapping> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="clinical.general"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="Partial mapping from messages containing the AL1 or IAM segment, such as the ADT^A01,
         ADT^A08, and ADT^A60."/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.id">
      <path value="DetectedIssue.id"/> 
      <short value="Logical id of this artifact"/> 
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned,
       this value never changes."/> 
      <comment value="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."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <!--  Note: special primitive values have a FHIRPath system type. e.g. this is compiler
       magic (j)  -->
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="DetectedIssue.meta">
      <path value="DetectedIssue.meta"/> 
      <short value="Metadata about the resource"/> 
      <definition value="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."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.meta"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Meta"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="DetectedIssue.implicitRules">
      <path value="DetectedIssue.implicitRules"/> 
      <short value="A set of rules under which this content was created"/> 
      <definition value="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."/> 
      <comment value="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."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.implicitRules"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional
       knowledge about the resource that modifies its meaning or interpretation"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="DetectedIssue.language">
      <path value="DetectedIssue.language"/> 
      <short value="Language of the resource content"/> 
      <definition value="The base language in which the resource is written."/> 
      <comment value="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)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.language"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="required"/> 
        <description value="IETF language tag for a human language"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/all-languages|6.0.0-cibuild"/> 
        <additional> 
          <purpose value="starter"/> 
          <valueSet value="http://hl7.org/fhir/ValueSet/languages"/> 
        </additional> 
      </binding> 
    </element> 
    <element id="DetectedIssue.text">
      <path value="DetectedIssue.text"/> 
      <short value="Text summary of the resource, for human interpretation"/> 
      <definition value="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
       &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions
       may define what content should be represented in the narrative to ensure clinical
       safety."/> 
      <comment value="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 &quot;text blob&quot; or where text is additionally entered raw or narrated
       and encoded information is added later."/> 
      <alias value="narrative"/> 
      <alias value="html"/> 
      <alias value="xhtml"/> 
      <alias value="display"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DomainResource.text"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Narrative"/> 
      </type> 
      <condition value="dom-6"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Act.text?"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.contained">
      <path value="DetectedIssue.contained"/> 
      <short value="Contained, inline Resources"/> 
      <definition value="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."/> 
      <comment value="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."/> 
      <alias value="inline resources"/> 
      <alias value="anonymous resources"/> 
      <alias value="contained resources"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.contained"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Resource"/> 
      </type> 
      <condition value="dom-2"/> 
      <condition value="dom-4"/> 
      <condition value="dom-3"/> 
      <condition value="dom-5"/> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.extension">
      <path value="DetectedIssue.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="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."/> 
      <comment value="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."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.modifierExtension">
      <path value="DetectedIssue.modifierExtension"/> 
      <short value="Extensions that cannot be ignored"/> 
      <definition value="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)."/> 
      <comment value="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."/> 
      <requirements value="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](extensibility.html#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       resource that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.identifier">
      <path value="DetectedIssue.identifier"/> 
      <short value="Unique id for the detected issue"/> 
      <definition value="Business identifier associated with the detected issue record."/> 
      <requirements value="Allows linking instances of the same detected issue found on different servers."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DetectedIssue.identifier"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Identifier"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="IAM-7"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".id"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.status">
      <path value="DetectedIssue.status"/> 
      <short value="preliminary | final | entered-in-error | mitigated"/> 
      <definition value="Indicates the status of the detected issue."/> 
      <comment value="This element is labeled as a modifier because the status contains the code entered-in-error
       that marks the issue as not currently valid."/> 
      <alias value="status"/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="DetectedIssue.status"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="This element is labeled as a modifier because it is a status element that contains
       the code entered-in-error which means that the resource should not be treated as
       valid"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DetectedIssueStatus"/> 
        </extension> 
        <strength value="required"/> 
        <description value="Indicates the status of the identified issue."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/detectedissue-status|6.0.0-cibuild"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.status"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.status"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".statusCode"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.category">
      <path value="DetectedIssue.category"/> 
      <short value="Type of detected issue, e.g. drug-drug, duplicate therapy, etc"/> 
      <definition value="A code that classifies the general type of detected issue."/> 
      <comment value="In addition to the required category valueset, this element allows various categorization
       schemes based on the owner’s definition of the category and effectively multiple
       categories can be used at once.  The level of granularity is defined by the category
       concepts in the value set."/> 
      <requirements value="Used for filtering what detected issues are retrieved and displayed."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DetectedIssue.category"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DetectedIssueCategory"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="Codes for high level detected issue categories."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/detectedissue-category"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.category"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.class"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=&quot;COMP].target[classCode=&quot;LIST&quot;, moodCode=&quot;
        EVN&quot;].code"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.code">
      <path value="DetectedIssue.code"/> 
      <short value="Specific type of detected issue, e.g. drug-drug, duplicate therapy, etc"/> 
      <definition value="Identifies the specific type of issue identified."/> 
      <alias value="type"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DetectedIssue.code"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DetectedIssueCategory"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="Codes identifying the type of detected issue; e.g. Drug-drug interaction, Timing
         issue, Duplicate therapy, etc."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/detectedissue-category"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.code"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.class"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="AL1-2 / IAM-9"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.severity">
      <path value="DetectedIssue.severity"/> 
      <short value="high | moderate | low"/> 
      <definition value="Indicates the degree of importance associated with the identified issue based on
       the potential impact on the patient."/> 
      <alias value="severity"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DetectedIssue.severity"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DetectedIssueSeverity"/> 
        </extension> 
        <strength value="required"/> 
        <description value="Indicates the potential degree of impact of the identified issue on the patient."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/detectedissue-severity|6.0.0-cibuild"/> 
      </binding> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.grade"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="AL1-4/ IAR-2"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV].value"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.subject">
      <path value="DetectedIssue.subject"/> 
      <short value="Associated subject"/> 
      <definition value="Indicates the subject whose record the detected issue is associated with."/> 
      <requirements value="While the subject could be inferred by tracing the subject of the implicated resources,
       it's useful to have a direct link for query purposes."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DetectedIssue.subject"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Medication"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Substance"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/BiologicallyDerivedProduct"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/NutritionProduct"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.subject"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="PID-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=SBJ].role[classCode=PAT]"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.encounter">
      <path value="DetectedIssue.encounter"/> 
      <short value="Encounter detected issue is part of"/> 
      <definition value="The encounter during which this issue was detected."/> 
      <comment value="This will typically be the encounter the DetectedIssue was created during, but
       some DetectedIssues may be initiated prior to or after the official completion
       of an encounter but still be tied to the context of the encounter (e.g. pre-admission
       lab tests)."/> 
      <requirements value="Links this detected issue to the Encounter context."/> 
      <alias value="context"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DetectedIssue.encounter"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.encounter"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.context"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="PV1-19 Visit Number"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=&quot;type
         of encounter or episode&quot;]"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.identified[x]">
      <path value="DetectedIssue.identified[x]"/> 
      <short value="When identified"/> 
      <definition value="The date or period when the detected issue was initially identified."/> 
      <requirements value="No-one can be responsible for mitigation prior to the issue being identified."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DetectedIssue.identified[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <type> 
        <code value="Period"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.occurrence[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.recorded"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="ALI-6 / IAM-11"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".effectiveTime"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.author">
      <path value="DetectedIssue.author"/> 
      <short value="The provider or device that identified the issue"/> 
      <definition value="Individual or device responsible for the issue being raised.  For example, a decision
       support application or a pharmacist conducting a medication review."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DetectedIssue.author"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.performer.actor"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.author"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="IAM-14 / IAM-16"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT].role[classCode=ASSIGNED]"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.implicated">
      <path value="DetectedIssue.implicated"/> 
      <short value="Problem resource"/> 
      <definition value="Indicates the resource representing the current activity or proposed activity that
       is potentially problematic."/> 
      <comment value="There's an implicit constraint on the number of implicated resources based on DetectedIssue.t
      ype; e.g. For drug-drug, there would be more than one.  For timing, there would
       typically only be one."/> 
      <alias value="cause"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DetectedIssue.implicated"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.reason"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=SUBJ].target[moodCode=EVN, INT]"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.evidence">
      <path value="DetectedIssue.evidence"/> 
      <short value="Supporting evidence"/> 
      <definition value="Supporting evidence or manifestations that provide the basis for identifying the
       detected issue such as a GuidanceResponse or MeasureReport."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DetectedIssue.evidence"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.why[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=EVID].target[classCode=ACT, moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.evidence.id">
      <path value="DetectedIssue.evidence.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <!--  Note: special primitive values have a FHIRPath system type. e.g. this is compiler
       magic (j)  -->
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.evidence.extension">
      <path value="DetectedIssue.evidence.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="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."/> 
      <comment value="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."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.evidence.modifierExtension">
      <path value="DetectedIssue.evidence.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="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)."/> 
      <comment value="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."/> 
      <requirements value="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](extensibility.html#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.evidence.code">
      <path value="DetectedIssue.evidence.code"/> 
      <short value="Manifestation"/> 
      <definition value="A manifestation that led to the recording of this detected issue."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DetectedIssue.evidence.code"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DetectedIssueEvidenceCode"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Codes that describes the types of evidence for a detected issue."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/manifestation-or-symptom"/> 
      </binding> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.why[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.evidence.detail">
      <path value="DetectedIssue.evidence.detail"/> 
      <short value="Supporting information"/> 
      <definition value="Links to resources that constitute evidence for the detected issue such as a GuidanceResponse
       or MeasureReport."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DetectedIssue.evidence.detail"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.why[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".text"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.detail">
      <path value="DetectedIssue.detail"/> 
      <short value="Description and context"/> 
      <definition value="A textual explanation of the detected issue."/> 
      <comment value="Should focus on information not covered elsewhere as discrete data - no need to
       duplicate the narrative."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DetectedIssue.detail"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.note"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="AL1-5 / IAM-8"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".text"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.reference">
      <path value="DetectedIssue.reference"/> 
      <short value="Authority for issue"/> 
      <definition value="The literature, knowledge-base or similar reference that describes the propensity
       for the detected issue identified."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DetectedIssue.reference"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=INST].target[classCode=ALRT, moodCode=DEFN].text.uri"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.mitigation">
      <path value="DetectedIssue.mitigation"/> 
      <short value="Step taken to address"/> 
      <definition value="Indicates an action that has been taken or is committed to reduce or eliminate
       the likelihood of the risk identified by the detected issue from manifesting. 
       Can also reflect an observation of known mitigating factors that may reduce/eliminate
       the need for any action."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DetectedIssue.mitigation"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=MITG].target[classCode=ACT, moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.mitigation.id">
      <path value="DetectedIssue.mitigation.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <!--  Note: special primitive values have a FHIRPath system type. e.g. this is compiler
       magic (j)  -->
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.mitigation.extension">
      <path value="DetectedIssue.mitigation.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="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."/> 
      <comment value="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."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.mitigation.modifierExtension">
      <path value="DetectedIssue.mitigation.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="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)."/> 
      <comment value="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."/> 
      <requirements value="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](extensibility.html#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.mitigation.action">
      <path value="DetectedIssue.mitigation.action"/> 
      <short value="What mitigation?"/> 
      <definition value="Describes the action that was taken or the observation that was made that reduces/eliminates
       the risk associated with the identified issue."/> 
      <comment value="The &quot;text&quot; component can be used for detail or when no appropriate code
       exists."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="DetectedIssue.mitigation.action"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DetectedIssueMitigationAction"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="Codes describing steps taken to resolve the issue or other circumstances that mitigate
         the risk associated with the issue; e.g. 'added concurrent therapy', 'prior therapy
         documented', etc."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/detectedissue-mitigation-action"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.mitigation.date">
      <path value="DetectedIssue.mitigation.date"/> 
      <short value="Date committed"/> 
      <definition value="Indicates when the mitigating action was documented."/> 
      <comment value="This might not be the same as when the mitigating step was actually taken."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DetectedIssue.mitigation.date"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".effectiveTime"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.mitigation.author">
      <path value="DetectedIssue.mitigation.author"/> 
      <short value="Who is committing?"/> 
      <definition value="Identifies the practitioner who determined the mitigation and takes responsibility
       for the mitigation step occurring."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DetectedIssue.mitigation.author"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT].role[classCode=ASSIGNED]"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.mitigation.note">
      <path value="DetectedIssue.mitigation.note"/> 
      <short value="Additional notes about the mitigation"/> 
      <definition value="Clinicians may add additional notes or justifications about the mitigation action.
       For example, patient can have this drug because they have had it before without
       any issues. Multiple justifications may be provided."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DetectedIssue.mitigation.note"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Annotation"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT].role[classCode=ASSIGNED].note"/> 
      </mapping> 
    </element> 
  </snapshot> 
  <differential> 
    <element id="DetectedIssue">
      <path value="DetectedIssue"/> 
      <short value="Clinical issue with action"/> 
      <definition value="Indicates an actual or potential clinical issue with or between one or more active
       or proposed clinical actions for a patient; e.g. Drug-drug interaction, Ineffective
       treatment frequency, Procedure-condition conflict, gaps in care, etc."/> 
      <alias value="DDI"/> 
      <alias value="drug-drug interaction"/> 
      <alias value="Contraindication"/> 
      <alias value="Alert"/> 
      <min value="0"/> 
      <max value="*"/> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="clinical.general"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="Partial mapping from messages containing the AL1 or IAM segment, such as the ADT^A01,
         ADT^A08, and ADT^A60."/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Observation[classCode=ALRT, moodCode=EVN)"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.identifier">
      <path value="DetectedIssue.identifier"/> 
      <short value="Unique id for the detected issue"/> 
      <definition value="Business identifier associated with the detected issue record."/> 
      <requirements value="Allows linking instances of the same detected issue found on different servers."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Identifier"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="IAM-7"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".id"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.status">
      <path value="DetectedIssue.status"/> 
      <short value="preliminary | final | entered-in-error | mitigated"/> 
      <definition value="Indicates the status of the detected issue."/> 
      <comment value="This element is labeled as a modifier because the status contains the code entered-in-error
       that marks the issue as not currently valid."/> 
      <alias value="status"/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="code"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="This element is labeled as a modifier because it is a status element that contains
       the code entered-in-error which means that the resource should not be treated as
       valid"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DetectedIssueStatus"/> 
        </extension> 
        <strength value="required"/> 
        <description value="Indicates the status of the identified issue."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/detectedissue-status|6.0.0-cibuild"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.status"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.status"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".statusCode"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.category">
      <path value="DetectedIssue.category"/> 
      <short value="Type of detected issue, e.g. drug-drug, duplicate therapy, etc"/> 
      <definition value="A code that classifies the general type of detected issue."/> 
      <comment value="In addition to the required category valueset, this element allows various categorization
       schemes based on the owner’s definition of the category and effectively multiple
       categories can be used at once.  The level of granularity is defined by the category
       concepts in the value set."/> 
      <requirements value="Used for filtering what detected issues are retrieved and displayed."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DetectedIssueCategory"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="Codes for high level detected issue categories."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/detectedissue-category"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.category"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.class"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=&quot;COMP].target[classCode=&quot;LIST&quot;, moodCode=&quot;
        EVN&quot;].code"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.code">
      <path value="DetectedIssue.code"/> 
      <short value="Specific type of detected issue, e.g. drug-drug, duplicate therapy, etc"/> 
      <definition value="Identifies the specific type of issue identified."/> 
      <alias value="type"/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DetectedIssueCategory"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="Codes identifying the type of detected issue; e.g. Drug-drug interaction, Timing
         issue, Duplicate therapy, etc."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/detectedissue-category"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.code"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.class"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="AL1-2 / IAM-9"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.severity">
      <path value="DetectedIssue.severity"/> 
      <short value="high | moderate | low"/> 
      <definition value="Indicates the degree of importance associated with the identified issue based on
       the potential impact on the patient."/> 
      <alias value="severity"/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="code"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DetectedIssueSeverity"/> 
        </extension> 
        <strength value="required"/> 
        <description value="Indicates the potential degree of impact of the identified issue on the patient."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/detectedissue-severity|6.0.0-cibuild"/> 
      </binding> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.grade"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="AL1-4/ IAR-2"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV].value"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.subject">
      <path value="DetectedIssue.subject"/> 
      <short value="Associated subject"/> 
      <definition value="Indicates the subject whose record the detected issue is associated with."/> 
      <requirements value="While the subject could be inferred by tracing the subject of the implicated resources,
       it's useful to have a direct link for query purposes."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Medication"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Substance"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/BiologicallyDerivedProduct"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/NutritionProduct"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.subject"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="PID-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=SBJ].role[classCode=PAT]"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.encounter">
      <path value="DetectedIssue.encounter"/> 
      <short value="Encounter detected issue is part of"/> 
      <definition value="The encounter during which this issue was detected."/> 
      <comment value="This will typically be the encounter the DetectedIssue was created during, but
       some DetectedIssues may be initiated prior to or after the official completion
       of an encounter but still be tied to the context of the encounter (e.g. pre-admission
       lab tests)."/> 
      <requirements value="Links this detected issue to the Encounter context."/> 
      <alias value="context"/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.encounter"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.context"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="PV1-19 Visit Number"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=&quot;type
         of encounter or episode&quot;]"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.identified[x]">
      <path value="DetectedIssue.identified[x]"/> 
      <short value="When identified"/> 
      <definition value="The date or period when the detected issue was initially identified."/> 
      <requirements value="No-one can be responsible for mitigation prior to the issue being identified."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <type> 
        <code value="Period"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.occurrence[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.recorded"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="ALI-6 / IAM-11"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".effectiveTime"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.author">
      <path value="DetectedIssue.author"/> 
      <short value="The provider or device that identified the issue"/> 
      <definition value="Individual or device responsible for the issue being raised.  For example, a decision
       support application or a pharmacist conducting a medication review."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.performer.actor"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.author"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="IAM-14 / IAM-16"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT].role[classCode=ASSIGNED]"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.implicated">
      <path value="DetectedIssue.implicated"/> 
      <short value="Problem resource"/> 
      <definition value="Indicates the resource representing the current activity or proposed activity that
       is potentially problematic."/> 
      <comment value="There's an implicit constraint on the number of implicated resources based on DetectedIssue.t
      ype; e.g. For drug-drug, there would be more than one.  For timing, there would
       typically only be one."/> 
      <alias value="cause"/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.reason"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=SUBJ].target[moodCode=EVN, INT]"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.evidence">
      <path value="DetectedIssue.evidence"/> 
      <short value="Supporting evidence"/> 
      <definition value="Supporting evidence or manifestations that provide the basis for identifying the
       detected issue such as a GuidanceResponse or MeasureReport."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.why[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=EVID].target[classCode=ACT, moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.evidence.code">
      <path value="DetectedIssue.evidence.code"/> 
      <short value="Manifestation"/> 
      <definition value="A manifestation that led to the recording of this detected issue."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DetectedIssueEvidenceCode"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Codes that describes the types of evidence for a detected issue."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/manifestation-or-symptom"/> 
      </binding> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.why[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.evidence.detail">
      <path value="DetectedIssue.evidence.detail"/> 
      <short value="Supporting information"/> 
      <definition value="Links to resources that constitute evidence for the detected issue such as a GuidanceResponse
       or MeasureReport."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.why[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".text"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.detail">
      <path value="DetectedIssue.detail"/> 
      <short value="Description and context"/> 
      <definition value="A textual explanation of the detected issue."/> 
      <comment value="Should focus on information not covered elsewhere as discrete data - no need to
       duplicate the narrative."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.note"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="AL1-5 / IAM-8"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".text"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.reference">
      <path value="DetectedIssue.reference"/> 
      <short value="Authority for issue"/> 
      <definition value="The literature, knowledge-base or similar reference that describes the propensity
       for the detected issue identified."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="uri"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=INST].target[classCode=ALRT, moodCode=DEFN].text.uri"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.mitigation">
      <path value="DetectedIssue.mitigation"/> 
      <short value="Step taken to address"/> 
      <definition value="Indicates an action that has been taken or is committed to reduce or eliminate
       the likelihood of the risk identified by the detected issue from manifesting. 
       Can also reflect an observation of known mitigating factors that may reduce/eliminate
       the need for any action."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=MITG].target[classCode=ACT, moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.mitigation.action">
      <path value="DetectedIssue.mitigation.action"/> 
      <short value="What mitigation?"/> 
      <definition value="Describes the action that was taken or the observation that was made that reduces/eliminates
       the risk associated with the identified issue."/> 
      <comment value="The &quot;text&quot; component can be used for detail or when no appropriate code
       exists."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DetectedIssueMitigationAction"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="Codes describing steps taken to resolve the issue or other circumstances that mitigate
         the risk associated with the issue; e.g. 'added concurrent therapy', 'prior therapy
         documented', etc."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/detectedissue-mitigation-action"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.mitigation.date">
      <path value="DetectedIssue.mitigation.date"/> 
      <short value="Date committed"/> 
      <definition value="Indicates when the mitigating action was documented."/> 
      <comment value="This might not be the same as when the mitigating step was actually taken."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".effectiveTime"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.mitigation.author">
      <path value="DetectedIssue.mitigation.author"/> 
      <short value="Who is committing?"/> 
      <definition value="Identifies the practitioner who determined the mitigation and takes responsibility
       for the mitigation step occurring."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT].role[classCode=ASSIGNED]"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.mitigation.note">
      <path value="DetectedIssue.mitigation.note"/> 
      <short value="Additional notes about the mitigation"/> 
      <definition value="Clinicians may add additional notes or justifications about the mitigation action.
       For example, patient can have this drug because they have had it before without
       any issues. Multiple justifications may be provided."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Annotation"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT].role[classCode=ASSIGNED].note"/> 
      </mapping> 
    </element> 
  </differential> 
</StructureDefinition> 

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.