Clinical Practice Guidelines
2.0.0-draft - draft International flag

Clinical Practice Guidelines, published by HL7 International / Clinical Decision Support. This guide is not an authorized publication; it is the continuous build for version 2.0.0-draft built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/cqf-recommendations/ and changes regularly. See the Directory of published versions

Resource Profile: CPGRecordDetectedIssueActivity - Detailed Descriptions

Active as of 2024-10-03

Definitions for the cpg-recorddetectedissueactivity resource profile.

Guidance on how to interpret the contents of this table can be found here

0. ActivityDefinition
2. ActivityDefinition.kind
Fixed ValueTask
4. ActivityDefinition.profile
Definition

The profile that the resulting communication request must conform to; at least a CPGCommunicationRequest, though the activity definition may introduce further constraints.

ShortAt least a CPG CommunicationRequest
Control1..?
Fixed Valuehttp://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-recorddetectedissuetask
6. ActivityDefinition.intent
Control1..?
Must Supporttrue
Fixed Valueproposal
8. ActivityDefinition.doNotPerform
Control1..?
Must Supporttrue

Guidance on how to interpret the contents of this table can be found here

0. ActivityDefinition
Definition

This resource allows for the definition of some activity to be performed, independent of a particular patient, practitioner, or other performance context.

ShortThe definition of a specific activity to be taken, independent of any particular patient or context
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsadf-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
adf-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
2. ActivityDefinition.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. ActivityDefinition.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

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.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. ActivityDefinition.status
Definition

The status of this activity definition. Enables tracking the life-cycle of the content.

Shortdraft | active | retired | unknown
Comments

Allows filtering of activity definitions that are appropriate for use versus not.

Control1..1
BindingThe codes SHALL be taken from PublicationStatushttp://hl7.org/fhir/ValueSet/publication-status|4.0.1
(required to http://hl7.org/fhir/ValueSet/publication-status|4.0.1)

The lifecycle status of an artifact.

Typecode
Is Modifiertrue because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. ActivityDefinition.subject[x]
Definition

A code or group definition that describes the intended subject of the activity being defined.

ShortType of individual the activity definition is intended for
Control0..1
BindingUnless not suitable, these codes SHALL be taken from SubjectTypehttp://hl7.org/fhir/ValueSet/subject-type
(extensible to http://hl7.org/fhir/ValueSet/subject-type)

The possible types of subjects for an activity (E.g. Patient, Practitioner, Organization, Location, etc.).

TypeChoice of: CodeableConcept, Reference(Group)
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Is Modifierfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summaryfalse
Meaning if MissingPatient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. ActivityDefinition.library
Definition

A reference to a Library resource containing any formal logic used by the activity definition.

ShortLogic used by the activity definition
Control0..1*
Typecanonical(Library)
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. ActivityDefinition.kind
Definition

A description of the kind of resource the activity definition is representing. For example, a MedicationRequest, a ServiceRequest, or a CommunicationRequest. Typically, but not always, this is a Request resource.

ShortKind of resource
Comments

May determine what types of extensions are permitted.

Control10..1
BindingThe codes SHALL be taken from RequestResourceTypehttp://hl7.org/fhir/ValueSet/request-resource-types|4.0.1
(required to http://hl7.org/fhir/ValueSet/request-resource-types|4.0.1)

The kind of activity the definition is describing.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Fixed ValueTask
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. ActivityDefinition.profile
Definition

The profile that the resulting communication request must conform to; at least a CPGCommunicationRequest, though the activity definition may introduce further constraints.


A profile to which the target of the activity definition is expected to conform.

ShortAt least a CPG CommunicationRequestWhat profile the resource needs to conform to
Control10..1
Typecanonical(StructureDefinition)
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Requirements

Allows profiles to be used to describe the types of activities that can be performed within a workflow, protocol, or order set.

Fixed Valuehttp://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-recorddetectedissuetask
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. ActivityDefinition.code
Definition

Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter.

ShortDetail type of activity
Comments

Tends to be less relevant for activities involving particular products.

Control0..1
BindingFor example codes, see ProcedureCodes(SNOMEDCT)http://hl7.org/fhir/ValueSet/procedure-code
(example to http://hl7.org/fhir/ValueSet/procedure-code)

Detailed type of the activity; e.g. CBC.

TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

Allows matching performed to planned as well as validation against protocols.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. ActivityDefinition.intent
Definition

Indicates the level of authority/intentionality associated with the activity and where the request should fit into the workflow chain.

Shortproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Control10..1
BindingThe codes SHALL be taken from RequestIntenthttp://hl7.org/fhir/ValueSet/request-intent|4.0.1
(required to http://hl7.org/fhir/ValueSet/request-intent|4.0.1)

Codes indicating the degree of authority/intentionality associated with a request.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valueproposal
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. ActivityDefinition.doNotPerform
Definition

Set this to true if the definition is to indicate that a particular activity should NOT be performed. If true, this element should be interpreted to reinforce a negative coding. For example NPO as a code with a doNotPerform of true would still indicate to NOT perform the action.

ShortTrue if the activity should not be performed
Comments

This element is not intended to be used to communicate a decision support response to cancel an order in progress. That should be done with the "remove" type of a PlanDefinition or RequestGroup.

Control10..1
Typeboolean
Is Modifiertrue because If true this element negates the specified action. For Example, instead of a request for a procedure, it is a request for the procedure to not occur.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. ActivityDefinition.timing[x]
Definition

The period, timing or frequency upon which the described activity is to occur.

ShortWhen activity is to occur
Control0..1
TypeChoice of: Timing, dateTime, Age, Period, Range, Duration
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summaryfalse
Requirements

Allows prompting for activities and detection of missed planned activities.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. ActivityDefinition.location
Definition

Identifies the facility where the activity will occur; e.g. home, hospital, specific clinic, etc.

ShortWhere it should happen
Comments

May reference a specific clinical location or may just identify a type of location.

Control0..1
TypeReference(Location)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Requirements

Helps in planning of activity.

Alternate Namesfacility
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. ActivityDefinition.participant
Definition

Indicates who should participate in performing the action described.

ShortWho should participate in the action
Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. ActivityDefinition.participant.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element 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 manageable, 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).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
30. ActivityDefinition.participant.type
Definition

The type of participant in the action.

Shortpatient | practitioner | related-person | device
Control1..1
BindingThe codes SHALL be taken from ActionParticipantTypehttp://hl7.org/fhir/ValueSet/action-participant-type|4.0.1
(required to http://hl7.org/fhir/ValueSet/action-participant-type|4.0.1)

The type of participant in the activity.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. ActivityDefinition.dynamicValue
Definition

Dynamic values that will be evaluated to produce values for elements of the resulting resource. For example, if the dosage of a medication must be computed based on the patient's weight, a dynamic value would be used to specify an expression that calculated the weight, and the path on the request resource that would contain the result.

ShortDynamic aspects of the definition
Comments

Dynamic values are applied in the order in which they are defined in the ActivityDefinition. Note that if both a transform and dynamic values are specified, the dynamic values will be applied to the result of the transform.

Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. ActivityDefinition.dynamicValue.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element 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 manageable, 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).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
36. ActivityDefinition.dynamicValue.path
Definition

The path to the element to be customized. This is the path on the resource that will hold the result of the calculation defined by the expression. The specified path SHALL be a FHIRPath resolveable on the specified target type of the ActivityDefinition, and SHALL consist only of identifiers, constant indexers, and a restricted subset of functions. The path is allowed to contain qualifiers (.) to traverse sub-elements, as well as indexers ([x]) to traverse multiple-cardinality sub-elements (see the Simple FHIRPath Profile for full details).

ShortThe path to the element to be set dynamically
Comments

The path attribute contains a Simple FHIRPath Subset that allows path traversal, but not calculation.

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. ActivityDefinition.dynamicValue.expression
Definition

An expression specifying the value of the customized element.

ShortAn expression that provides the dynamic value for the customization
Comments

The expression may be inlined, or may be a reference to a named expression within a logic library referenced by the library element.

Control1..1
TypeExpression
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be found here

0. ActivityDefinition
Definition

This resource allows for the definition of some activity to be performed, independent of a particular patient, practitioner, or other performance context.

ShortThe definition of a specific activity to be taken, independent of any particular patient or context
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsadf-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. ActivityDefinition.id
Definition

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

ShortLogical id of this artifact
Comments

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

Control0..1
Typeid
Is Modifierfalse
Summarytrue
4. ActivityDefinition.meta
Definition

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.

ShortMetadata about the resource
Control0..1
TypeMeta
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. ActivityDefinition.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. ActivityDefinition.language
Definition

The base language in which the resource is written.

ShortLanguage of the resource content
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Control0..1
BindingThe codes SHOULD be taken from CommonLanguages
(preferred to http://hl7.org/fhir/ValueSet/languages)

A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. ActivityDefinition.text
Definition

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 "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

ShortText summary of the resource, for human interpretation
Comments

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

Control0..1
TypeNarrative
Is Modifierfalse
Summaryfalse
Alternate Namesnarrative, html, xhtml, display
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. ActivityDefinition.contained
Definition

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

ShortContained, inline Resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Control0..*
TypeResource
Is Modifierfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
14. ActivityDefinition.extension
Definition

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 manageable, 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.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
16. ActivityDefinition.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

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.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. ActivityDefinition.url
Definition

An absolute URI that is used to identify this activity definition when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this activity definition is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the activity definition is stored on different servers.

ShortCanonical identifier for this activity definition, represented as a URI (globally unique)
Comments

Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version.

The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in Technical and Business Versions.

In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the meta.source element to indicate where the current master source of the resource can be found.

Control0..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the activity definition to be referenced by a single globally unique identifier.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. ActivityDefinition.identifier
Definition

A formal identifier that is used to identify this activity definition when it is represented in other formats, or referenced in a specification, model, design or an instance.

ShortAdditional identifier for the activity definition
Comments

Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this activity definition outside of FHIR, where it is not possible to use the logical URI.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Summarytrue
Requirements

Allows externally provided and/or usable business identifiers to be easily associated with the module.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. ActivityDefinition.version
Definition

The identifier that is used to identify this version of the activity definition when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the activity definition author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. To provide a version consistent with the Decision Support Service specification, use the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer to the Decision Support Service specification. Note that a version is required for non-experimental active assets.

ShortBusiness version of the activity definition
Comments

There may be different activity definition instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the activity definition with the format [url]|[version].

NoteThis is a business version Id, not a resource version Id (see discussion)
Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. ActivityDefinition.name
Definition

A natural language name identifying the activity definition. This name should be usable as an identifier for the module by machine processing applications such as code generation.

ShortName for this activity definition (computer friendly)
Comments

The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

Control0..1
This element is affected by the following invariants: inv-0
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Support human navigation and code generation.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. ActivityDefinition.title
Definition

A short, descriptive, user-friendly title for the activity definition.

ShortName for this activity definition (human friendly)
Comments

This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. ActivityDefinition.subtitle
Definition

An explanatory or alternate title for the activity definition giving additional information about its content.

ShortSubordinate title of the activity definition
Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. ActivityDefinition.status
Definition

The status of this activity definition. Enables tracking the life-cycle of the content.

Shortdraft | active | retired | unknown
Comments

Allows filtering of activity definitions that are appropriate for use versus not.

Control1..1
BindingThe codes SHALL be taken from PublicationStatus
(required to http://hl7.org/fhir/ValueSet/publication-status|4.0.1)

The lifecycle status of an artifact.

Typecode
Is Modifiertrue because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. ActivityDefinition.experimental
Definition

A Boolean value to indicate that this activity definition is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.

ShortFor testing purposes, not real usage
Comments

Allows filtering of activity definitions that are appropriate for use versus not.

Control0..1
Typeboolean
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Enables experimental content to be developed following the same lifecycle that would be used for a production-level activity definition.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. ActivityDefinition.subject[x]
Definition

A code or group definition that describes the intended subject of the activity being defined.

ShortType of individual the activity definition is intended for
Control0..1
BindingUnless not suitable, these codes SHALL be taken from SubjectType
(extensible to http://hl7.org/fhir/ValueSet/subject-type)

The possible types of subjects for an activity (E.g. Patient, Practitioner, Organization, Location, etc.).

TypeChoice of: CodeableConcept, Reference(Group)
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Is Modifierfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summaryfalse
Meaning if MissingPatient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. ActivityDefinition.date
Definition

The date (and optionally time) when the activity definition was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the activity definition changes.

ShortDate last changed
Comments

Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the activity definition. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

Control0..1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate NamesRevision Date
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. ActivityDefinition.publisher
Definition

The name of the organization or individual that published the activity definition.

ShortName of the publisher (organization or individual)
Comments

Usually an organization but may be an individual. The publisher (or steward) of the activity definition is the organization or individual primarily responsible for the maintenance and upkeep of the activity definition. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the activity definition. This item SHOULD be populated unless the information is available from context.

Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Helps establish the "authority/credibility" of the activity definition. May also allow for contact.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. ActivityDefinition.contact
Definition

Contact details to assist a user in finding and communicating with the publisher.

ShortContact details for the publisher
Comments

May be a web site, an email address, a telephone number, etc.

Control0..*
TypeContactDetail
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. ActivityDefinition.description
Definition

A free text natural language description of the activity definition from a consumer's perspective.

ShortNatural language description of the activity definition
Comments

This description can be used to capture details such as why the activity definition was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the activity definition as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the activity definition is presumed to be the predominant language in the place the activity definition was created).

Control0..1
Typemarkdown
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. ActivityDefinition.useContext
Definition

The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate activity definition instances.

ShortThe context that the content is intended to support
Comments

When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

Control0..*
TypeUsageContext
Is Modifierfalse
Summarytrue
Requirements

Assist in searching for appropriate content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. ActivityDefinition.jurisdiction
Definition

A legal or geographic region in which the activity definition is intended to be used.

ShortIntended jurisdiction for activity definition (if applicable)
Comments

It may be possible for the activity definition to be used in jurisdictions other than those for which it was originally designed or intended.

Control0..*
BindingUnless not suitable, these codes SHALL be taken from Jurisdiction ValueSet
(extensible to http://hl7.org/fhir/ValueSet/jurisdiction)

Countries and regions within which this artifact is targeted for use.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. ActivityDefinition.purpose
Definition

Explanation of why this activity definition is needed and why it has been designed as it has.

ShortWhy this activity definition is defined
Comments

This element does not describe the usage of the activity definition. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this activity definition.

Control0..1
Typemarkdown
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. ActivityDefinition.usage
Definition

A detailed description of how the activity definition is used from a clinical perspective.

ShortDescribes the clinical usage of the activity definition
Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. ActivityDefinition.copyright
Definition

A copyright statement relating to the activity definition and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the activity definition.

ShortUse and/or publishing restrictions
Control0..1
Typemarkdown
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Requirements

Consumers must be able to determine any legal restrictions on the use of the activity definition and/or its content.

Alternate NamesLicense, Restrictions
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. ActivityDefinition.approvalDate
Definition

The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.

ShortWhen the activity definition was approved by publisher
Comments

The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.

Control0..1
Typedate
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. ActivityDefinition.lastReviewDate
Definition

The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.

ShortWhen the activity definition was last reviewed
Comments

If specified, this date follows the original approval date.

Control0..1
Typedate
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Requirements

Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. ActivityDefinition.effectivePeriod
Definition

The period during which the activity definition content was or is planned to be in active use.

ShortWhen the activity definition is expected to be used
Comments

The effective period for a activity definition determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015.

Control0..1
TypePeriod
Is Modifierfalse
Summarytrue
Requirements

Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of the activity definition are or are expected to be used instead.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. ActivityDefinition.topic
Definition

Descriptive topics related to the content of the activity. Topics provide a high-level categorization of the activity that can be useful for filtering and searching.

ShortE.g. Education, Treatment, Assessment, etc.
Control0..*
BindingFor example codes, see DefinitionTopic
(example to http://hl7.org/fhir/ValueSet/definition-topic)

High-level categorization of the definition, used for searching, sorting, and filtering.

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Requirements

Repositories must be able to determine how to categorize the activity definition so that it can be found by topical searches.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. ActivityDefinition.author
Definition

An individiual or organization primarily involved in the creation and maintenance of the content.

ShortWho authored the content
Control0..*
TypeContactDetail
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. ActivityDefinition.editor
Definition

An individual or organization primarily responsible for internal coherence of the content.

ShortWho edited the content
Control0..*
TypeContactDetail
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
66. ActivityDefinition.reviewer
Definition

An individual or organization primarily responsible for review of some aspect of the content.

ShortWho reviewed the content
Control0..*
TypeContactDetail
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. ActivityDefinition.endorser
Definition

An individual or organization responsible for officially endorsing the content for use in some setting.

ShortWho endorsed the content
Control0..*
TypeContactDetail
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
70. ActivityDefinition.relatedArtifact
Definition

Related artifacts such as additional documentation, justification, or bibliographic references.

ShortAdditional documentation, citations, etc.
Comments

Each related artifact is either an attachment, or a reference to another resource, but not both.

Control0..*
TypeRelatedArtifact
Is Modifierfalse
Summaryfalse
Requirements

Activity definitions must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
72. ActivityDefinition.library
Definition

A reference to a Library resource containing any formal logic used by the activity definition.

ShortLogic used by the activity definition
Control0..1
Typecanonical(Library)
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
74. ActivityDefinition.kind
Definition

A description of the kind of resource the activity definition is representing. For example, a MedicationRequest, a ServiceRequest, or a CommunicationRequest. Typically, but not always, this is a Request resource.

ShortKind of resource
Comments

May determine what types of extensions are permitted.

Control1..1
BindingThe codes SHALL be taken from RequestResourceType
(required to http://hl7.org/fhir/ValueSet/request-resource-types|4.0.1)

The kind of activity the definition is describing.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Fixed ValueTask
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
76. ActivityDefinition.profile
Definition

The profile that the resulting communication request must conform to; at least a CPGCommunicationRequest, though the activity definition may introduce further constraints.

ShortAt least a CPG CommunicationRequest
Control1..1
Typecanonical(StructureDefinition)
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Requirements

Allows profiles to be used to describe the types of activities that can be performed within a workflow, protocol, or order set.

Fixed Valuehttp://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-recorddetectedissuetask
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
78. ActivityDefinition.code
Definition

Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter.

ShortDetail type of activity
Comments

Tends to be less relevant for activities involving particular products.

Control0..1
BindingFor example codes, see ProcedureCodes(SNOMEDCT)
(example to http://hl7.org/fhir/ValueSet/procedure-code)

Detailed type of the activity; e.g. CBC.

TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

Allows matching performed to planned as well as validation against protocols.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
80. ActivityDefinition.intent
Definition

Indicates the level of authority/intentionality associated with the activity and where the request should fit into the workflow chain.

Shortproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Control1..1
BindingThe codes SHALL be taken from RequestIntent
(required to http://hl7.org/fhir/ValueSet/request-intent|4.0.1)

Codes indicating the degree of authority/intentionality associated with a request.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valueproposal
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
82. ActivityDefinition.priority
Definition

Indicates how quickly the activity should be addressed with respect to other requests.

Shortroutine | urgent | asap | stat
Control0..1
BindingThe codes SHALL be taken from RequestPriority
(required to http://hl7.org/fhir/ValueSet/request-priority|4.0.1)

Identifies the level of importance to be assigned to actioning the request.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
84. ActivityDefinition.doNotPerform
Definition

Set this to true if the definition is to indicate that a particular activity should NOT be performed. If true, this element should be interpreted to reinforce a negative coding. For example NPO as a code with a doNotPerform of true would still indicate to NOT perform the action.

ShortTrue if the activity should not be performed
Comments

This element is not intended to be used to communicate a decision support response to cancel an order in progress. That should be done with the "remove" type of a PlanDefinition or RequestGroup.

Control1..1
Typeboolean
Is Modifiertrue because If true this element negates the specified action. For Example, instead of a request for a procedure, it is a request for the procedure to not occur.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
86. ActivityDefinition.timing[x]
Definition

The period, timing or frequency upon which the described activity is to occur.

ShortWhen activity is to occur
Control0..1
TypeChoice of: Timing, dateTime, Age, Period, Range, Duration
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summaryfalse
Requirements

Allows prompting for activities and detection of missed planned activities.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
88. ActivityDefinition.location
Definition

Identifies the facility where the activity will occur; e.g. home, hospital, specific clinic, etc.

ShortWhere it should happen
Comments

May reference a specific clinical location or may just identify a type of location.

Control0..1
TypeReference(Location)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Requirements

Helps in planning of activity.

Alternate Namesfacility
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
90. ActivityDefinition.participant
Definition

Indicates who should participate in performing the action described.

ShortWho should participate in the action
Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
92. ActivityDefinition.participant.id
Definition

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

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
94. ActivityDefinition.participant.extension
Definition

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 manageable, 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.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
96. ActivityDefinition.participant.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element 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 manageable, 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).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
98. ActivityDefinition.participant.type
Definition

The type of participant in the action.

Shortpatient | practitioner | related-person | device
Control1..1
BindingThe codes SHALL be taken from ActionParticipantType
(required to http://hl7.org/fhir/ValueSet/action-participant-type|4.0.1)

The type of participant in the activity.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
100. ActivityDefinition.participant.role
Definition

The role the participant should play in performing the described action.

ShortE.g. Nurse, Surgeon, Parent, etc.
Control0..1
BindingFor example codes, see ActionParticipantRole
(example to http://hl7.org/fhir/ValueSet/action-participant-role)

Defines roles played by participants for the action.

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
102. ActivityDefinition.product[x]
Definition

Identifies the food, drug or other product being consumed or supplied in the activity.

ShortWhat's administered/supplied
Control0..1
BindingFor example codes, see SNOMEDCTMedicationCodes
(example to http://hl7.org/fhir/ValueSet/medication-codes)

Code describing the type of substance or medication.

TypeChoice of: Reference(Medication, Substance), CodeableConcept
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
104. ActivityDefinition.quantity
Definition

Identifies the quantity expected to be consumed at once (per dose, per meal, etc.).

ShortHow much is administered/consumed/supplied
Control0..1
TypeQuantity(SimpleQuantity)
Is Modifierfalse
Summaryfalse
Alternate Namesdose
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
106. ActivityDefinition.dosage
Definition

Provides detailed dosage instructions in the same way that they are described for MedicationRequest resources.

ShortDetailed dosage instructions
Comments

If a dosage instruction is used, the definition should not specify timing or quantity.

Control0..*
TypeDosage
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
108. ActivityDefinition.bodySite
Definition

Indicates the sites on the subject's body where the procedure should be performed (I.e. the target sites).

ShortWhat part of body to perform on
Comments

Only used if not implicit in the code found in ServiceRequest.type.

Control0..*
BindingFor example codes, see SNOMEDCTBodyStructures
(example to http://hl7.org/fhir/ValueSet/body-site)

A code that identifies the anatomical location.

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Requirements

Knowing where the procedure is made is important for tracking if multiple sites are possible.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
110. ActivityDefinition.specimenRequirement
Definition

Defines specimen requirements for the action to be performed, such as required specimens for a lab test.

ShortWhat specimens are required to perform this action
Control0..*
TypeReference(SpecimenDefinition)
Is Modifierfalse
Summaryfalse
Requirements

Needed to represent lab order definitions.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
112. ActivityDefinition.observationRequirement
Definition

Defines observation requirements for the action to be performed, such as body weight or surface area.

ShortWhat observations are required to perform this action
Control0..*
TypeReference(ObservationDefinition)
Is Modifierfalse
Summaryfalse
Requirements

Needed to represent observation definitions.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
114. ActivityDefinition.observationResultRequirement
Definition

Defines the observations that are expected to be produced by the action.

ShortWhat observations must be produced by this action
Control0..*
TypeReference(ObservationDefinition)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
116. ActivityDefinition.transform
Definition

A reference to a StructureMap resource that defines a transform that can be executed to produce the intent resource using the ActivityDefinition instance as the input.

ShortTransform to apply the template
Comments

Note that if both a transform and dynamic values are specified, the dynamic values will be applied to the result of the transform.

Control0..1
Typecanonical(StructureMap)
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
118. ActivityDefinition.dynamicValue
Definition

Dynamic values that will be evaluated to produce values for elements of the resulting resource. For example, if the dosage of a medication must be computed based on the patient's weight, a dynamic value would be used to specify an expression that calculated the weight, and the path on the request resource that would contain the result.

ShortDynamic aspects of the definition
Comments

Dynamic values are applied in the order in which they are defined in the ActivityDefinition. Note that if both a transform and dynamic values are specified, the dynamic values will be applied to the result of the transform.

Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
120. ActivityDefinition.dynamicValue.id
Definition

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

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
122. ActivityDefinition.dynamicValue.extension
Definition

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 manageable, 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.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
124. ActivityDefinition.dynamicValue.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element 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 manageable, 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).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
126. ActivityDefinition.dynamicValue.path
Definition

The path to the element to be customized. This is the path on the resource that will hold the result of the calculation defined by the expression. The specified path SHALL be a FHIRPath resolveable on the specified target type of the ActivityDefinition, and SHALL consist only of identifiers, constant indexers, and a restricted subset of functions. The path is allowed to contain qualifiers (.) to traverse sub-elements, as well as indexers ([x]) to traverse multiple-cardinality sub-elements (see the Simple FHIRPath Profile for full details).

ShortThe path to the element to be set dynamically
Comments

The path attribute contains a Simple FHIRPath Subset that allows path traversal, but not calculation.

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
128. ActivityDefinition.dynamicValue.expression
Definition

An expression specifying the value of the customized element.

ShortAn expression that provides the dynamic value for the customization
Comments

The expression may be inlined, or may be a reference to a named expression within a logic library referenced by the library element.

Control1..1
TypeExpression
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))