Canonical Resource Management Infrastructure Implementation Guide
1.1.0-cibuild - cibuild International flag

Canonical Resource Management Infrastructure Implementation Guide, published by HL7 International / Clinical Decision Support. This guide is not an authorized publication; it is the continuous build for version 1.1.0-cibuild built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/crmi-ig/ and changes regularly. See the Directory of published versions

Resource Profile: CRMIPublishableActivityDefinition - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 3

Definitions for the crmi-publishableactivitydefinition resource profile.

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
Control10..1*
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.extension:usage
Slice Nameusage
Definition

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

ShortDescribes the clinical usage of the artifact
Control0..1
TypeExtension(Artifact Usage) (Extension Type: markdown)
Is Modifierfalse
Must Supporttrue
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())
ele-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.extension:copyrightLabel
Slice NamecopyrightLabel
Definition

A short string (<50 characters), suitable for inclusion in a page footer that identifies the copyright holder, effective period, and optionally whether rights are resctricted. (e.g. 'All rights reserved', 'Some rights reserved').

ShortCopyright holder and year(s)
Comments

Defines the content expected to be rendered in all representations of the artifact. The (c) symbol should NOT be included in this string. It is expected to be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.

Control0..1
TypeExtension(Artifact Copyright Label) (Extension Type: string)
Is Modifierfalse
Must Supporttrue
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())
ele-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())
8. 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())
10. 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
Must Supporttrue
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()))
12. 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()))
14. 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.

Control10..1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Alternate NamesRevision Date
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. 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
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. 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
Must Supporttrue
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()))
20. 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 ValueSethttp://hl7.org/fhir/ValueSet/jurisdiction
(extensible to http://hl7.org/fhir/ValueSet/jurisdiction)

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

TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. 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
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. 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
Must Supporttrue
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()))
26. 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
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. 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
Must Supporttrue
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()))
30. 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
Must Supporttrue
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()))
32. 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 DefinitionTopichttp://hl7.org/fhir/ValueSet/definition-topic
(example to http://hl7.org/fhir/ValueSet/definition-topic)

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

TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
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()))
34. 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
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. ActivityDefinition.editor
Definition

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

ShortWho edited the content
Control0..*
TypeContactDetail
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. 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
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. 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
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. 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
Must Supporttrue
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()))
44. ActivityDefinition.relatedArtifact.type
Definition

The type of relationship to the related artifact.

Shortdocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Control1..1
BindingThe codes SHALL be taken from RelatedArtifactTypehttp://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1
(required to http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1)

The type of relationship to the related artifact.

Typecode
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()))
46. ActivityDefinition.relatedArtifact.display
Definition

A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.

ShortBrief description of the related artifact
Control0..1
Typestring
Is Modifierfalse
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()))
48. ActivityDefinition.relatedArtifact.document
Definition

The document being referenced, represented as an attachment. This is exclusive with the resource element.

ShortWhat document is being referenced
Control0..1
TypeAttachment
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. ActivityDefinition.relatedArtifact.resource
Definition

The related resource, such as a library, value set, profile, or other knowledge resource.

ShortWhat resource is being referenced
Comments

If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.

Control0..1
Typecanonical(Resource)
Is Modifierfalse
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()))
52. 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.

Control0..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
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))