Clinical Practice Guidelines (CPG) on EBMonFHIR
1.0.1 - ci-build

Clinical Practice Guidelines (CPG) on EBMonFHIR, published by Universitätsmedizin Greifswald. This guide is not an authorized publication; it is the continuous build for version 1.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/CEOsys/cpg-on-ebm-on-fhir/ and changes regularly. See the Directory of published versions

Resource Profile: Recommendation Plan

Defining URL:https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/StructureDefinition/recommendation-plan
Version:0.3.0
Name:RecommendationPlan
Title:Recommendation Plan
Status:Draft as of 2022-12-08
Definition:

Definition of an activity that is part of an intervention in the context of a clinical practice guideline recommendation.

Publisher:Netzwerk Universitätsmedizin (NUM),
Source Resource:XML / JSON / Turtle

The official URL for this profile is: 

https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/StructureDefinition/recommendation-plan

Guidance

This profile defines a specific recommended plan as part of an intervention recommended by a specific Recommendation.

The actions to be performed are specified using the Recommendation Action.

Categories

The following categories are used to describe the intervention action in the Recommendation Plan profile.

The categories are defined as slices of the action element in the Recommendation Plan profile.

Fixed Codes:

In RecommendationPlan:

  • action.code  must be exactly as defined in the example
  • goal.category  must be exactly as defined in the example
Type .action Slice Name .goal Slice Name Action ProfileName
Drug Administration drugAdministration
❌ *not required*
Drug Administration Action
Laboratory Observation
❌ *not required*
⚠️ *this might change*
laboratoryValue n/a
Ventilation Measure/Setting ventilatorManagement ventilatorManagement n/a
Body position bodyPositioning
❌ *not required*
Body Positioning Action
Sedation Management sedationManagement assessmentScale n/a
Pain Management painManagement assessmentScale n/a
Assessment assessment any Assessment Action
Procedure procedure
❌ *not required*
Procedure Action
Any other / Custom other
❌ *not required*
n/a

For nested actions, you must use the combination slice of the action element in the Recommendation Plan profile.

Type .action Slice Name .goal Slice Name Action ProfileName
Nested Actions combination
*n/a*
*n/a*

Combinations

Action Combination

If at least one action is defined, the combination of actions is defined using the Action Combination Method Extension.

To ease the use of the extension, the following rulesets can be used:

Type Description Treshold required RuleSet
#exactly Exactly threshold actions out of the combination must be performed Yes rs-combination-exactly(threshold)
#at-least At least threshold actions out of the combination must be performed Yes rs-combination-at-least(threshold)
#at-most At most threshold actions out of the combination must be performed Yes rs-combination-at-most(threshold)
#one-or-more At least one action must be performed (equivalent to at-least with threshold=1) No rs-combination-one-or-more
#all All actions must be performed No rs-combination-all
#any Any combination of actions (but at least one) must be performed (equivalent to at-least with threshold=1) No rs-combination-any

Aliases

Alias: $combinationMethod = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/StructureDefinition/ext-action-combination-method
Alias: $cs-action-combination-method = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/cs-action-combination-method

Exactly

// in RecommendationPlan instance
* insert rs-combination-exactly(2)

results in

* extension[$combinationMethod].extension[method].valueCodeableConcept = $cs-action-combination-method#exactly
* extension[$combinationMethod].extension[threshold].valuePositiveInt = 2

At-Least

// in RecommendationPlan instance
* insert rs-combination-at-least(2)

results in

* extension[$combinationMethod].extension[method].valueCodeableConcept = $cs-action-combination-method#at-least
* extension[$combinationMethod].extension[threshold].valuePositiveInt = 2

At-Most

// in RecommendationPlan instance
* insert rs-combination-at-most(2)

results in

* extension[$combinationMethod].extension[method].valueCodeableConcept = $cs-action-combination-method#at-most
* extension[$combinationMethod].extension[threshold].valuePositiveInt = 2

One-Or-More

// in RecommendationPlan instance
* insert rs-combination-one-or-more

results in

* extension[$combinationMethod].extension[method].valueCodeableConcept = $cs-action-combination-method#one-or-more

All

// in RecommendationPlan instance
* insert rs-combination-all

results in

* extension[$combinationMethod].extension[method].valueCodeableConcept = $cs-action-combination-method#all

Any

// in RecommendationPlan instance
* insert rs-combination-any

results in

* extension[$combinationMethod].extension[method].valueCodeableConcept = $cs-action-combination-method#any

Examples

Drug Administration
// in RecommendationPlan instance
* action[drugAdministration][+]
  // code *must* use the code below
  * code = $sct#432102000 "Administration of substance (procedure)"
  * definitionCanonical = Canonical(ExampleDrugAdministrationAction)

// in ExampleDrugAdministrationAction
Instance: ExampleDrugAdministrationAction
InstanceOf: drug-administration-action
Usage: #example
Title: "Example DrugAdministration Action"
Description: "An active DrugAdministration action."
* name = "DrugAdministrationAction"
* status = #active
* url = "https://www.ceosys.de/fhir/canonical/recommendation-action/drug-administration-example"
* productCodeableConcept = $sct#372584003 "Dexamethasone (substance)"
* dosage
  * route = $sct#26643006 "Oral route"
  * timing
    * repeat
      * count = 10
      * duration = 10
      * durationUnit = $ucum#d "d"
      * frequency = 1
      * period = 1
      * periodUnit = $ucum#d "d"
  * doseAndRate
    * doseQuantity = 6 'mg' "mg"
    * rateQuantity = 1 '/d' "/d"
Laboratory Observation
// in RecommendationPlan instance
* goal[laboratoryValue][+]
  // category *must* use the code below
  * category = $sct#410394004 "Lab findings surveillance (regime/therapy)"
  * id = "lab-ddimer-concentration-goal"
  * description.text = "D-Dimer concentration shall be below 250 ng/mL"
  * target
    * measure = $loinc#48066-5 "Fibrin D-dimer DDU [Mass/volume] in Platelet poor plasma"
    * detailRange
      * high = 250 'ng/mL'
Ventilation Measure/Setting
// in RecommendationPlan instance
* action[ventilatorManagement][+]
  // code *must* use the code below
  * code = $sct#410210009 "Ventilator care management (procedure)"
  * goalId[+] = "ventilator-management-goal" // note that goalId must match the id of the goal

* goal[ventilatorManagement][+]
  // category *must* use the code below
  * category = $sct#385857005 "Ventilator care and adjustment (regime/therapy)"
  * id = "ventilator-management-goal"
  * description.text = "The ventilator should be set up to provide a breath reate of at least 20 and at most per minute."
  * target
    * measure = $loinc#33438-3 "Breath rate mechanical --on ventilator"
    * detailRange
      * low = 20 '/min'
      * high = 24 '/min'
Body Position
// in RecommendationPlan instance
* action[bodyPositioning][+]
  // code *must* use the code below
  * code = $sct#229824005 "Positioning patient (procedure)"
  * definitionCanonical = Canonical(ExampleBodyPositioningAction)

// in ExampleBodyPositioningAction
Instance: ExampleBodyPositioningAction
InstanceOf: body-positioning-action
Usage: #example
Title: "Example Body Positioning Action"
Description: "Example of a body positioning action."
* name = "DrugAdministrationAction"
* status = #active
* url = "https://www.ceosys.de/fhir/canonical/recommendation-action/body-positioning-example"
* code = $sct#431182000 "Placing subject in prone position (procedure)"
Sedation Management
// in RecommendationPlan instance
* action[sedationManagement][+]
  * code = $sct#406187008 "Sedation management (regime/therapy)"
  * goalId[+] = "sedation-management-RASS-0-goal"

* goal[assessmentScale][+]
  * id = "sedation-management-RASS-0-goal"
  * description.text = "RASS should be 0 or 1"
  * category = $sct#273249006 "Assessment scales (assessment scale)"
  * target
    * measure = $sct-us#457441000124102 "Richmond agitation-sedation scale"
    * detailRange
      * low = -1 'score'
      * high = 0 'score'
Pain Management
// in RecommendationPlan instance
* action[painManagement][+]
  * code = $sct#278414003 "Pain management (procedure)"
  * goalId[+] = "pain-management-goal"

* goal[assessmentScale][+]
  * id = "pain-management-goal"
  * description.text = "NRS should not be >4"
  * target
    * measure = $loinc#72514-3 "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
    * detailRange
      * high = 3 'score'
Assessment
// in RecommendationPlan instance
* action[assessment][+]
  * definitionCanonical = Canonical (PainMonitoringNRS)
  * selectionBehavior = #one-or-more
  * code = $sct#386053000 "Evaluation procedure (procedure)"


// in PainMonitoringNRS
Instance: PainMonitoringNRS
InstanceOf: assessment-action
Usage: #definition
Title: "Pain Monitoring with NRS"
Description: "Pain Monitoring in ICU Patients with NRS"
* insert canonical-url(patients-icu-pain-monitoring, recommended-action/pain-monitoring-NRS)
* insert publisher-experimental-version(0.1)
* name = "PainMonitoringWithNRSPlan"
* status = #active
* description = "Pain monitoring in ICU Patients with NRS"
* code = $loinc#72514-3 "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
* timingTiming.code = #Q8H

The RelativeTime datatype can be used via the RelativeTime extension on the action field to define the timing of the action.

This profile of a FHIR PlanDefinition is derived from the cpg-recommendationdefinition FHIR resource.

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

NameFlagsCard.TypeDescription & Constraintsdoco
.. PlanDefinition C 1..1 CPGRecommendationDefinition The definition of a plan for a series of actions, independent of any specific patient or context
cnl-0: Name should be usable as an identifier for the module by machine processing applications such as code generation
pld-3: goalid should reference the id of a goal definition
pld-4: targetId should reference the id of an action
selection-behavior-unique-or-no-value: If selectionBehavior is present, it must be the same for all actions in the group
nested-action-requires-combination-method: If a nested action is present, a combination method must be present.
... id Σ 0..1 id Logical id of this artifact
... meta SΣ 1..1 Meta Metadata about the resource
.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated Σ 0..1 instant When the resource version last changed
.... source SΣ 0..1 uri Identifies where the resource comes from
.... profile SΣ 1..* canonical(StructureDefinition) Profiles this resource claims to conform to
.... security Σ 0..* Coding Security Labels applied to this resource
Binding: AllSecurityLabels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: AllLanguages (required): IETF language tag for a human language

Additional BindingsPurpose
CommonLanguages Starter Set
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 4..* Extension Extension
Slice: Unordered, Open by value:url
.... knowledgeCapability S 1..1 (Complex) shareable | computable | publishable | executable
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability"
..... value[x] 1..1 code Value of extension
Binding: CPG Knowledge Capability (required): A knowledge capability provided by a knowledge artifact


Required Pattern: computable
.... knowledgeRepresentationLevel S 1..1 (Complex) narrative | semi-structured | structured | executable
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeRepresentationLevel
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeRepresentationLevel"
..... value[x] 1..1 code Value of extension
Binding: CPG Knowledge Representation Level (required): A level of knowledge representation provided by this artifact


Required Pattern: structured
.... artifactComment S 0..* (Complex) Additional documentation, review, or usage guidance
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-artifactComment
.... enabled S 0..1 boolean Enabled?
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-enabled
.... partOf S 1..1 (Complex) Part of pathway
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-partOf
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-partOf"
..... value[x] S 1..1 canonical(Recommendation) Value of extension
.... combinationMethod S 1..1 (Complex) combinationMethod
URL: https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/StructureDefinition/ext-action-combination-method
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
... url SΣC 1..1 uri Canonical identifier for this plan definition, represented as a URI (globally unique)
cnl-1: URL should not contain | or # - these characters make processing canonical references problematic
... identifier Σ 0..* Identifier Additional identifier for the plan definition
... version SΣ 1..1 string Business version of the plan definition
... versionAlgorithm[x] SΣ 0..1 How to compare versions
Binding: VersionAlgorithm (extensible)
.... versionAlgorithmString string
.... versionAlgorithmCoding Coding
... name SΣC 1..1 string Name for this plan definition (computer friendly)
... title SΣ 1..1 string Name for this plan definition (human friendly)
... subtitle 0..1 string Subordinate title of the plan definition
... type SΣ 1..1 CodeableConcept order-set | clinical-protocol | eca-rule | workflow-definition
Binding: PlanDefinitionType (extensible): The type of PlanDefinition.


Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/plan-definition-type
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: eca-rule
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... status ?!Σ 1..1 code draft | active | retired | unknown
Binding: PublicationStatus (required): The lifecycle status of an artifact.

... experimental SΣ 0..1 boolean For testing purposes, not real usage
... subject[x] S 1..1 canonical(Recommendation Eligibility Criteria) Type of individual the plan definition is focused on
... date Σ 1..1 dateTime Date last changed
... publisher SΣ 0..1 string Name of the publisher/steward (organization or individual)
... contact Σ 0..* ContactDetail Contact details for the publisher
... description SΣ 1..1 markdown Natural language description of the plan definition
... useContext Σ 0..* UsageContext The context that the content is intended to support
... jurisdiction Σ 0..* CodeableConcept Intended jurisdiction for plan definition (if applicable)
Binding: JurisdictionValueSet (extensible): Countries and regions within which this artifact is targeted for use.


... purpose 0..1 markdown Why this plan definition is defined
... usage 0..1 markdown Describes the clinical usage of the plan
... copyright 0..1 markdown Use and/or publishing restrictions
... copyrightLabel 0..1 string Copyright holder and year(s)
... approvalDate 0..1 date When the plan definition was approved by publisher
... lastReviewDate 0..1 date When the plan definition was last reviewed by the publisher
... effectivePeriod Σ 0..1 Period When the plan definition is expected to be used
... topic 0..* CodeableConcept E.g. Education, Treatment, Assessment
Binding: DefinitionTopic (example): High-level categorization of the definition, used for searching, sorting, and filtering.


... author 0..* ContactDetail Who authored the content
... editor 0..* ContactDetail Who edited the content
... reviewer 0..* ContactDetail Who reviewed the content
... endorser 0..* ContactDetail Who endorsed the content
... relatedArtifact 0..* RelatedArtifact Additional documentation, citations
... library S 0..1 canonical(Library) Logic used by the plan definition
... Slices for goal SC 0..* BackboneElement What the plan is trying to accomplish
Slice: Unordered, Closed by pattern:category
.... goal:All Slices Content/Rules for all slices
..... id S 1..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... category S 1..1 CodeableConcept E.g. Treatment, dietary, behavioral
Binding: GoalCategory (example): Example codes for grouping goals for filtering or presentation.

...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 1..* Coding Code defined by a terminology system
....... id 0..1 id Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
....... version Σ 0..1 string Version of the system - if relevant
....... code ΣC 1..1 code Symbol in syntax defined by the system
....... display ΣC 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... description 1..1 CodeableConcept Code or text describing the goal
Binding: SNOMEDCTClinicalFindings (example): Describes goals that can be achieved.

..... priority 0..1 CodeableConcept high-priority | medium-priority | low-priority
Binding: GoalPriority (preferred): Indicates the level of importance associated with reaching or sustaining a goal.

..... start 0..1 CodeableConcept When goal pursuit begins
Binding: GoalStartEvent (example): Identifies the types of events that might trigger the start of a goal.

..... addresses 0..* CodeableConcept What does the goal address
Binding: ConditionProblemDiagnosisCodes (example): Identifies problems, conditions, issues, or concerns that goals may address.


..... documentation 0..* RelatedArtifact Supporting documentation for the goal
..... target 0..* BackboneElement Target outcome for the goal
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... measure 0..1 CodeableConcept The parameter whose value is to be tracked
Binding: LOINCCodes (example): Identifies types of parameters that can be tracked to determine goal achievement.

...... detail[x] 0..1 The target value to be achieved
....... detailQuantity Quantity
....... detailRange Range
....... detailCodeableConcept CodeableConcept
....... detailString string
....... detailBoolean boolean
....... detailInteger integer
....... detailRatio Ratio
...... due 0..1 Duration Reach goal within
.... goal:ventilatorManagement C 0..* BackboneElement What the plan is trying to accomplish
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... category 0..1 CodeableConcept E.g. Treatment, dietary, behavioral
Binding: GoalCategory (example): Example codes for grouping goals for filtering or presentation.


Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 385857005
....... display 1..1 string Representation defined by the system
Fixed Value: Ventilator care and adjustment (regime/therapy)
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... description 1..1 CodeableConcept Code or text describing the goal
Binding: SNOMEDCTClinicalFindings (example): Describes goals that can be achieved.

..... priority 0..1 CodeableConcept high-priority | medium-priority | low-priority
Binding: GoalPriority (preferred): Indicates the level of importance associated with reaching or sustaining a goal.

..... start 0..1 CodeableConcept When goal pursuit begins
Binding: GoalStartEvent (example): Identifies the types of events that might trigger the start of a goal.

..... addresses 0..* CodeableConcept What does the goal address
Binding: ConditionProblemDiagnosisCodes (example): Identifies problems, conditions, issues, or concerns that goals may address.


..... documentation 0..* RelatedArtifact Supporting documentation for the goal
..... target 1..* BackboneElement Target outcome for the goal
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... measure S 1..1 CodeableConcept The parameter whose value is to be tracked
Binding: VS MII ICU Code Observation Beatmung [LOINC] (extensible)
...... detail[x] S 1..1 The target value to be achieved
....... detailQuantity Quantity
....... detailRange Range
....... detailCodeableConcept CodeableConcept
....... detailString string
....... detailBoolean boolean
....... detailInteger integer
....... detailRatio Ratio
...... due 0..1 Duration Reach goal within
.... goal:laboratoryValue C 0..* BackboneElement What the plan is trying to accomplish
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... category 0..1 CodeableConcept E.g. Treatment, dietary, behavioral
Binding: GoalCategory (example): Example codes for grouping goals for filtering or presentation.


Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 410394004
....... display 1..1 string Representation defined by the system
Fixed Value: Lab findings surveillance (regime/therapy)
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... description 1..1 CodeableConcept Code or text describing the goal
Binding: SNOMEDCTClinicalFindings (example): Describes goals that can be achieved.

..... priority 0..1 CodeableConcept high-priority | medium-priority | low-priority
Binding: GoalPriority (preferred): Indicates the level of importance associated with reaching or sustaining a goal.

..... start 0..1 CodeableConcept When goal pursuit begins
Binding: GoalStartEvent (example): Identifies the types of events that might trigger the start of a goal.

..... addresses 0..* CodeableConcept What does the goal address
Binding: ConditionProblemDiagnosisCodes (example): Identifies problems, conditions, issues, or concerns that goals may address.


..... documentation 0..* RelatedArtifact Supporting documentation for the goal
..... target 1..* BackboneElement Target outcome for the goal
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... measure S 1..1 CodeableConcept The parameter whose value is to be tracked
Binding: LOINCCodes (example): Identifies types of parameters that can be tracked to determine goal achievement.

....... id 0..1 id Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... coding Σ 0..* Coding Code defined by a terminology system

Required Pattern: At least the following
........ id 0..1 string Unique id for inter-element referencing
........ extension 0..* Extension Additional content defined by implementations
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
........ version 0..1 string Version of the system - if relevant
........ code 0..1 code Symbol in syntax defined by the system
........ display 0..1 string Representation defined by the system
........ userSelected 0..1 boolean If this coding was chosen directly by the user
........ id 0..1 id Unique id for inter-element referencing
........ extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
........ system SΣ 1..1 uri Identity of the terminology system
........ version Σ 0..1 string Version of the system - if relevant
........ code SΣC 1..1 code Symbol in syntax defined by the system
........ display ΣC 0..1 string Representation defined by the system
........ userSelected Σ 0..1 boolean If this coding was chosen directly by the user
....... text Σ 0..1 string Plain text representation of the concept
...... detail[x] S 1..1 The target value to be achieved
....... detailQuantity Quantity
....... detailRange Range
....... detailCodeableConcept CodeableConcept
....... detailString string
....... detailBoolean boolean
....... detailInteger integer
....... detailRatio Ratio
...... due 0..1 Duration Reach goal within
.... goal:assessmentScale C 0..* BackboneElement What the plan is trying to accomplish
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... category 0..1 CodeableConcept E.g. Treatment, dietary, behavioral
Binding: GoalCategory (example): Example codes for grouping goals for filtering or presentation.


Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 273249006
....... display 1..1 string Representation defined by the system
Fixed Value: Assessment scales (assessment scale)
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... description 1..1 CodeableConcept Code or text describing the goal
Binding: SNOMEDCTClinicalFindings (example): Describes goals that can be achieved.

..... priority 0..1 CodeableConcept high-priority | medium-priority | low-priority
Binding: GoalPriority (preferred): Indicates the level of importance associated with reaching or sustaining a goal.

..... start 0..1 CodeableConcept When goal pursuit begins
Binding: GoalStartEvent (example): Identifies the types of events that might trigger the start of a goal.

..... addresses 0..* CodeableConcept What does the goal address
Binding: ConditionProblemDiagnosisCodes (example): Identifies problems, conditions, issues, or concerns that goals may address.


..... documentation 0..* RelatedArtifact Supporting documentation for the goal
..... target 1..* BackboneElement Target outcome for the goal
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... measure S 1..1 CodeableConcept The parameter whose value is to be tracked
Binding: Assessment Scales (extensible)
...... detail[x] S 1..1 The target value to be achieved
....... detailQuantity Quantity
....... detailRange Range
....... detailCodeableConcept CodeableConcept
....... detailString string
....... detailBoolean boolean
....... detailInteger integer
....... detailRatio Ratio
...... due 0..1 Duration Reach goal within
.... goal:other C 0..* BackboneElement What the plan is trying to accomplish
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... category 0..1 CodeableConcept E.g. Treatment, dietary, behavioral
Binding: GoalCategory (example): Example codes for grouping goals for filtering or presentation.


Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 74964007
....... display 1..1 string Representation defined by the system
Fixed Value: Other (qualifier value)
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... description 1..1 CodeableConcept Code or text describing the goal
Binding: SNOMEDCTClinicalFindings (example): Describes goals that can be achieved.

..... priority 0..1 CodeableConcept high-priority | medium-priority | low-priority
Binding: GoalPriority (preferred): Indicates the level of importance associated with reaching or sustaining a goal.

..... start 0..1 CodeableConcept When goal pursuit begins
Binding: GoalStartEvent (example): Identifies the types of events that might trigger the start of a goal.

..... addresses 0..* CodeableConcept What does the goal address
Binding: ConditionProblemDiagnosisCodes (example): Identifies problems, conditions, issues, or concerns that goals may address.


..... documentation 0..* RelatedArtifact Supporting documentation for the goal
..... target 1..* BackboneElement Target outcome for the goal
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... measure S 1..1 CodeableConcept The parameter whose value is to be tracked
Binding: LOINCCodes (example): Identifies types of parameters that can be tracked to determine goal achievement.

...... detail[x] S 1..1 The target value to be achieved
....... detailQuantity Quantity
....... detailRange Range
....... detailCodeableConcept CodeableConcept
....... detailString string
....... detailBoolean boolean
....... detailInteger integer
....... detailRatio Ratio
...... due 0..1 Duration Reach goal within
... actor 0..* BackboneElement Actors within the plan
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... title 0..1 string User-visible title
.... description 0..1 markdown Describes the actor
.... option 1..* BackboneElement Who or what can be this actor
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type 0..1 code careteam | device | group | healthcareservice | location | organization | patient | practitioner | practitionerrole | relatedperson
Binding: ActionParticipantType (required): The type of participant in the activity.

..... typeCanonical 0..1 canonical(CapabilityStatement) Who or what can participate
..... typeReference 0..1 Reference(CareTeam | Device | DeviceDefinition | Endpoint | Group | HealthcareService | Location | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) Who or what can participate
..... role 0..1 CodeableConcept E.g. Nurse, Surgeon, Parent
Binding: Action Participant Role (example)
... Slices for action SC 1..* BackboneElement Action defined by the plan
Slice: Unordered, Closed by pattern:code
.... action:All Slices Content/Rules for all slices
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
...... strengthOfRecommendation S 0..1 CodeableConcept The strength of the recommendation
URL: https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/StructureDefinition/cqf-strengthOfRecommendation
Binding: StrengthOfRecommendationRating (example)
...... directionOfRecommendation S 0..1 CodeableConcept Recommendation for or against?
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-directionOfRecommendation
Binding: CPG Recommendation Direction (required): The direction of the recommendation, for or against


...... qualityOfEvidence S 0..1 CodeableConcept The quality of the evidence
URL: https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/StructureDefinition/cqf-qualityOfEvidence
Binding: QualityOfEvidenceRating (example)
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... linkId 0..1 string Unique id for the action in the PlanDefinition
..... prefix S 0..1 string User-visible prefix for the action (e.g. 1. or A.)
..... title S 0..1 string User-visible title
..... description S 0..1 markdown Brief description of the action
..... textEquivalent 0..1 markdown Static text equivalent of the action, used if the dynamic aspects cannot be interpreted by the receiving system
..... priority 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

..... code S 1..1 CodeableConcept Code representing the meaning of the action or sub-actions
Binding: ActionCode (example): Provides examples of actions to be performed.

...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 1..* Coding Code defined by a terminology system
....... id 0..1 id Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
....... version Σ 0..1 string Version of the system - if relevant
....... code ΣC 1..1 code Symbol in syntax defined by the system
....... display ΣC 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... reason S 0..* CodeableConcept Why the action should be performed
Binding: ActionReasonCode (example): Provides examples of reasons for actions to be performed.


..... documentation S 0..* RelatedArtifact Supporting documentation for the intended performer of the action
..... goalId C 0..* id What goals this action supports
..... subject[x] 0..1 Type of individual the action is focused on
Binding: ParticipantResourceTypes (extensible): The possible types of subjects for a plan definition (E.g. Patient, Practitioner, Organization, Location, etc.).

...... subjectCodeableConcept CodeableConcept
...... subjectReference Reference(Group)
...... subjectCanonical canonical(Any)
..... trigger S 0..* TriggerDefinition When the action should be triggered
..... condition S 0..* BackboneElement Whether or not the action is applicable
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... kind 1..1 code applicability | start | stop
Binding: ActionConditionKind (required): Defines the kinds of conditions that can appear on actions.

...... expression 0..1 Expression Boolean-valued expression
..... input C 0..* BackboneElement Pertinent positives and negatives relevant to determining applicability
pld-0: Input data elements must have a requirement or a relatedData, but not both
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... title 0..1 string User-visible title
...... requirement C 0..1 DataRequirement What data is provided
...... relatedData C 0..1 id What data is provided
..... output C 0..* BackboneElement Pertinent or relevant information that should be included with the recommendation
pld-1: Output data element must have a requirement or a relatedData, but not both
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... title 0..1 string User-visible title
...... requirement C 0..1 DataRequirement What data is provided
...... relatedData C 0..1 string What data is provided
..... relatedAction C 0..* BackboneElement Relationship to another action
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... targetId C 1..1 id What action is this related to
...... relationship 1..1 code before | before-start | before-end | concurrent | concurrent-with-start | concurrent-with-end | after | after-start | after-end
Binding: ActionRelationshipType (required): Defines the types of relationships between actions.

...... endRelationship 0..1 code before | before-start | before-end | concurrent | concurrent-with-start | concurrent-with-end | after | after-start | after-end
Binding: ActionRelationshipType (required): Defines the types of relationships between actions.

...... offset[x] 0..1 Time offset for the relationship
....... offsetDuration Duration
....... offsetRange Range
..... Slices for timing[x] S 0..1 When the action should take place
Slice: Unordered, Open by type:$this
...... timingAge Age
...... timingDuration Duration
...... timingRange Range
...... timingTiming Timing
...... timing[x]:timingTiming S 0..1 Timing When the action should take place
....... id 0..1 id Unique id for inter-element referencing
....... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
........ timingRelativeTime 0..* (Complex) Timing in which the characteristic is determined
URL: https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/StructureDefinition/relative-time
....... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
....... event Σ 0..* dateTime When the event occurs
....... repeat ΣC 0..1 Element When the event is to occur
tim-1: if there's a duration, there needs to be duration units
tim-2: if there's a period, there needs to be period units
tim-4: duration SHALL be a non-negative value
tim-5: period SHALL be a non-negative value
tim-6: If there's a periodMax, there must be a period
tim-7: If there's a durationMax, there must be a duration
tim-8: If there's a countMax, there must be a count
tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV)
tim-10: If there's a timeOfDay, there cannot be a when, or vice versa
........ id 0..1 string Unique id for inter-element referencing
........ extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
........ bounds[x] Σ 0..1 Length/Range of lengths, or (Start and/or end) limits
......... boundsDuration Duration
......... boundsRange Range
......... boundsPeriod Period
........ count ΣC 0..1 positiveInt Number of times to repeat
........ countMax ΣC 0..1 positiveInt Maximum number of times to repeat
........ duration ΣC 0..1 decimal How long when it happens
........ durationMax ΣC 0..1 decimal How long when it happens (Max)
........ durationUnit ΣC 0..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
Binding: UnitsOfTime (required): A unit of time (units from UCUM).

........ frequency Σ 0..1 positiveInt Indicates the number of repetitions that should occur within a period. I.e. Event occurs frequency times per period
........ frequencyMax Σ 0..1 positiveInt Event occurs up to frequencyMax times per period
........ period ΣC 0..1 decimal The duration to which the frequency applies. I.e. Event occurs frequency times per period
........ periodMax ΣC 0..1 decimal Upper limit of period (3-4 hours)
........ periodUnit ΣC 0..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
Binding: UnitsOfTime (required): A unit of time (units from UCUM).

........ dayOfWeek Σ 0..* code mon | tue | wed | thu | fri | sat | sun
Binding: DaysOfWeek (required)
........ timeOfDay ΣC 0..* time Time of day for action
........ when ΣC 0..* code Code for time period of occurrence
Binding: EventTiming (required): Real-world event relating to the schedule.


........ offset ΣC 0..1 unsignedInt Minutes from event (before or after)
....... code Σ 0..1 CodeableConcept C | BID | TID | QID | AM | PM | QD | QOD | +
Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern.

..... location 0..1 CodeableReference(Location) Where it should happen
..... participant S 0..* BackboneElement Who should participate in the action
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... actorId 0..1 string What actor
...... type 0..1 code careteam | device | group | healthcareservice | location | organization | patient | practitioner | practitionerrole | relatedperson
Binding: ActionParticipantType (required): The type of participant in the activity.

...... typeCanonical 0..1 canonical(CapabilityStatement) Who or what can participate
...... typeReference 0..1 Reference(CareTeam | Device | DeviceDefinition | Endpoint | Group | HealthcareService | Location | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) Who or what can participate
...... role S 0..1 CodeableConcept E.g. Nurse, Surgeon, Parent
Binding: CPG Common Persona (preferred): Personas used in identifying participants and their roles in computable content

...... function 0..1 CodeableConcept E.g. Author, Reviewer, Witness, etc
Binding: ActionParticipantFunction (example)
..... type S 0..1 CodeableConcept create | update | remove | fire-event
Binding: ActionType (extensible): The type of action to be performed.

..... groupingBehavior 0..1 code visual-group | logical-group | sentence-group
Binding: ActionGroupingBehavior (required): Defines organization behavior of a group.

..... selectionBehavior 0..1 code any | all | all-or-none | exactly-one | at-most-one | one-or-more
Binding: ActionSelectionBehavior (required): Defines selection behavior of a group.

..... requiredBehavior 0..1 code must | could | must-unless-documented
Binding: ActionRequiredBehavior (required): Defines expectations around whether an action or action group is required.

..... precheckBehavior 0..1 code yes | no
Binding: ActionPrecheckBehavior (required): Defines selection frequency behavior for an action or group.

..... cardinalityBehavior 0..1 code single | multiple
Binding: ActionCardinalityBehavior (required): Defines behavior for an action or a group for how many times that item may be repeated.

..... definition[x] S 0..1 canonical(ActivityDefinition | MessageDefinition | ObservationDefinition | PlanDefinition | Questionnaire | SpecimenDefinition) Description of the activity to be performed
..... transform 0..1 canonical(StructureMap) Transform to apply the template
..... dynamicValue S 0..* BackboneElement Dynamic aspects of the definition
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... path S 0..1 string The path to the element to be set dynamically
...... expression S 0..1 Expression An expression that provides the dynamic value for the customization
..... action S 0..* See action (PlanDefinition) A sub-action
.... action:combination SC 0..* BackboneElement Action defined by the plan
nested-action-requires-combination-method: If a nested action is present, a combination method must be present.
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
..... Slices for extension Content/Rules for all slices
...... strengthOfRecommendation S 0..1 CodeableConcept The strength of the recommendation
URL: https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/StructureDefinition/cqf-strengthOfRecommendation
Binding: StrengthOfRecommendationRating (example)
..... Slices for extension Content/Rules for all slices
...... directionOfRecommendation S 0..1 CodeableConcept Recommendation for or against?
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-directionOfRecommendation
Binding: CPG Recommendation Direction (required): The direction of the recommendation, for or against


..... Slices for extension Content/Rules for all slices
...... qualityOfEvidence S 0..1 CodeableConcept The quality of the evidence
URL: https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/StructureDefinition/cqf-qualityOfEvidence
Binding: QualityOfEvidenceRating (example)
..... Slices for extension Content/Rules for all slices
...... combinationMethod S 1..1 (Complex) combinationMethod
URL: https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/StructureDefinition/ext-action-combination-method
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... linkId 0..1 string Unique id for the action in the PlanDefinition
..... prefix S 0..1 string User-visible prefix for the action (e.g. 1. or A.)
..... title S 0..1 string User-visible title
..... description S 0..1 markdown Brief description of the action
..... textEquivalent 0..1 markdown Static text equivalent of the action, used if the dynamic aspects cannot be interpreted by the receiving system
..... priority 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

..... code S 0..1 CodeableConcept Code representing the meaning of the action or sub-actions
Binding: ActionCode (example): Provides examples of actions to be performed.


Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 89780004
....... display 1..1 string Representation defined by the system
Fixed Value: Combined (qualifier value)
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... reason S 0..* CodeableConcept Why the action should be performed
Binding: ActionReasonCode (example): Provides examples of reasons for actions to be performed.


..... documentation S 0..* RelatedArtifact Supporting documentation for the intended performer of the action
..... subject[x] 0..1 Type of individual the action is focused on
Binding: ParticipantResourceTypes (extensible): The possible types of subjects for a plan definition (E.g. Patient, Practitioner, Organization, Location, etc.).

...... subjectCodeableConcept CodeableConcept
...... subjectReference Reference(Group)
...... subjectCanonical canonical(Any)
..... trigger S 0..* TriggerDefinition When the action should be triggered
..... condition S 0..* BackboneElement Whether or not the action is applicable
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... kind 1..1 code applicability | start | stop
Binding: ActionConditionKind (required): Defines the kinds of conditions that can appear on actions.

...... expression 0..1 Expression Boolean-valued expression
..... input C 0..* BackboneElement Pertinent positives and negatives relevant to determining applicability
pld-0: Input data elements must have a requirement or a relatedData, but not both
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... title 0..1 string User-visible title
...... requirement C 0..1 DataRequirement What data is provided
...... relatedData C 0..1 id What data is provided
..... output C 0..* BackboneElement Pertinent or relevant information that should be included with the recommendation
pld-1: Output data element must have a requirement or a relatedData, but not both
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... title 0..1 string User-visible title
...... requirement C 0..1 DataRequirement What data is provided
...... relatedData C 0..1 string What data is provided
..... relatedAction C 0..* BackboneElement Relationship to another action
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... targetId C 1..1 id What action is this related to
...... relationship 1..1 code before | before-start | before-end | concurrent | concurrent-with-start | concurrent-with-end | after | after-start | after-end
Binding: ActionRelationshipType (required): Defines the types of relationships between actions.

...... endRelationship 0..1 code before | before-start | before-end | concurrent | concurrent-with-start | concurrent-with-end | after | after-start | after-end
Binding: ActionRelationshipType (required): Defines the types of relationships between actions.

...... offset[x] 0..1 Time offset for the relationship
....... offsetDuration Duration
....... offsetRange Range
..... Slices for timing[x] Content/Rules for all slices
.....