Generated Narrative: StructureDefinition deqm-detailedcaregapguidanceresponse Name Flags Card. Type Description & Constraints GuidanceResponse 0..* GuidanceResponse The formal response to a guidance request #xD; reasonCode 0..* CodeableConcept Why guidance is needed Binding: DEQM Care Gap Reasons Value Set (preferred) #xD; Slices for extension Content/Rules for all slices #xD; extension:detail 0..1 (Complex) Which data element attribute is the cause of the care gap URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-reasonDetail #xD; dataRequirement #xD; Slices for extension Content/Rules for all slices #xD; extension:valueFilter 0..* (Complex) What values are expected URL: http://hl7.org/fhir/StructureDefinition/cqf-valueFilter #xD; Documentation for this format
DEQM Detailed Care Gap Guidance Response
HL7 International / Clinical Quality Information
Derived from the GuidanceResponse resource, the Detailed Care Gap Guidance Response profile supports the functionality of providing reason for guidance and detailed guidance to help address care gaps and close open gaps.
The formal response to a guidance request
A guidance response is the formal response to a guidance request, including any output parameters returned by the evaluation, as well as the description of any proposed actions to be taken.
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
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()
not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
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()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If a resource is contained in another resource, it SHALL NOT have a security label
When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
A resource should have narrative for robust management
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
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.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
A set of rules under which this content was created
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.
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.
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
The base language in which the resource is written.
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).
Text summary of the resource, for human interpretation
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.
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.
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.
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.
Additional content defined by implementations
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.
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.
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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).
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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
The identifier of the request associated with this response, if any
The identifier of the request associated with this response. If an identifier was given as part of the request, it will be reproduced here to enable the requester to more easily identify the response in a multi-request scenario.
Allows a service to provide unique, business identifiers for the response.
An identifier, CodeableConcept or canonical reference to the guidance that was requested.
Event.instantiatesUri | Event.instantiatesCanonical
success | data-requested | data-required | in-progress | failure | entered-in-error
The status of the response. If the evaluation is completed successfully, the status will indicate success. However, in order to complete the evaluation, the engine may require more information. In this case, the status will be data-required, and the response will contain a description of the additional required information. If the evaluation completed successfully, but the engine determines that a potentially more accurate response could be provided if more data was available, the status will be data-requested, and the response will contain a description of the additional requested information.
This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
The patient for which the request was processed.
Encounter during which the response was returned
The encounter during which this response was created or to which the creation of this record is tightly associated.
This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official copmletion of an encounter but still be tied to the context of the encounter.
When the guidance response was processed
Indicates when the guidance response was processed.
Provides a reference to the device that performed the guidance.
Describes the reason for the guidance response in coded or textual form.
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
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.
Which data element attribute is the cause of the care gap
Refers back to the Resource and data element that cause the care gap defined by the reasonCode
A reference to a code defined by a terminology system.
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Allows for alternative encodings within a code system, and translations to other code systems.
fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Plain text representation of the concept
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Very often the text is the same as a displayName of one of the codings.
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
C*E.9. But note many systems use C*E.2 for this
fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Indicates the reason the request was initiated. This is typically provided as a parameter to the evaluation and echoed by the service, although for some use cases, such as subscription- or event-based scenarios, it may provide an indication of the cause for the response.
Provides a mechanism to communicate additional information about the response.
Messages resulting from the evaluation of the artifact or artifacts
Messages resulting from the evaluation of the artifact or artifacts. As part of evaluating the request, the engine may produce informational or warning messages. These messages will be provided by this element.
The output parameters of the evaluation, if any
The output parameters of the evaluation, if any. Many modules will result in the return of specific resources such as procedure or communication requests that are returned as part of the operation result. However, modules may define specific outputs that would be returned as the result of the evaluation, and these would be returned in this element.
The actions, if any, produced by the evaluation of the artifact.
If the evaluation could not be completed due to lack of information, or additional information would potentially result in a more accurate response, this element will a description of the data required in order to proceed with the evaluation. A subsequent request to the service should include this data.
Value Set filters specify additional constraints on the data for non coded or temporal types. Each value filter defines an additional constraint on the data, i.e. code filters are AND'ed, not OR'ed.
The type of the required data, specified as the type name of a resource. For profiles, this value is set to the type of the base resource of the profile.
A list of all the concrete types defined in this version of the FHIR specification - Abstract Types, Data Types and Resource Types.
The profile of the required data, specified as the uri of the profile definition.
E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device
The intended subjects of the data requirement. If this element is not provided, a Patient subject is assumed.
The subject of a data requirement is critical, as the data being specified is determined with respect to a particular subject. This corresponds roughly to the notion of a Compartment in that it limits what data is available based on its relationship to the subject. In CQL, this corresponds to the context declaration.
The possible types of subjects for a data requirement (E.g., Patient, Practitioner, Organization, Location, etc.).
Indicates specific structure elements that are referenced by the knowledge module
Indicates that specific elements of the type are referenced by the knowledge module and must be supported by the consumer in order to obtain an effective evaluation. This does not mean that a value is required for this element, only that the consuming system must understand the element and be able to provide values for it if they are available. The value of mustSupport SHALL be a FHIRPath resolveable on the type of the DataRequirement. The path SHALL consist only of identifiers, constant indexers, and .resolve() (see the [Simple FHIRPath Profile](http://hl7.org/fhir/R4/fhirpath.html#simple) for full details).
Code filters specify additional constraints on the data, specifying the value set of interest for a particular element of the data. Each code filter defines an additional constraint on the data, i.e. code filters are AND'ed, not OR'ed.
Either a path or a searchParam must be provided, but not both
(exists(f:path) and not(exists(f:searchParam))) or (not(exists(f:path)) and exists(f:searchParam))
The code-valued attribute of the filter. The specified path SHALL be a FHIRPath resolveable on the specified type of the DataRequirement, and SHALL consist only of identifiers, constant indexers, and .resolve(). 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](http://hl7.org/fhir/R4/fhirpath.html#simple) for full details). Note that the index must be an integer constant. The path must resolve to an element of type code, Coding, or CodeableConcept.
The path attribute contains a [Simple FHIRPath Subset](http://hl7.org/fhir/R4/fhirpath.html#simple) that allows path traversal, but not calculation.
A token parameter that refers to a search parameter defined on the specified type of the DataRequirement, and which searches on elements of type code, Coding, or CodeableConcept.
The valueset for the code filter. The valueSet and code elements are additive. If valueSet is specified, the filter will return only those data items for which the value of the code-valued element specified in the path is a member of the specified valueset.
The codes for the code filter. If values are given, the filter will return only those data items for which the code-valued attribute specified by the path has a value that is one of the specified codes. If codes are specified in addition to a value set, the filter returns items matching a code in the value set or one of the specified codes.
Date filters specify additional constraints on the data in terms of the applicable date range for specific elements. Each date filter specifies an additional constraint on the data, i.e. date filters are AND'ed, not OR'ed.
The date-valued attribute of the filter. The specified path SHALL be a FHIRPath resolveable on the specified type of the DataRequirement, and SHALL consist only of identifiers, constant indexers, and .resolve(). 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](http://hl7.org/fhir/R4/fhirpath.html#simple) for full details). Note that the index must be an integer constant. The path must resolve to an element of type date, dateTime, Period, Schedule, or Timing.
The path attribute contains a [Simple FHIR Subset](http://hl7.org/fhir/R4/fhirpath.html#simple) that allows path traversal, but not calculation.
A date parameter that refers to a search parameter defined on the specified type of the DataRequirement, and which searches on elements of type date, dateTime, Period, Schedule, or Timing.
The value of the filter, as a Period, DateTime, or Duration value
The value of the filter. If period is specified, the filter will return only those data items that fall within the bounds determined by the Period, inclusive of the period boundaries. If dateTime is specified, the filter will return only those data items that are equal to the specified dateTime. If a Duration is specified, the filter will return only those data items that fall within Duration before now.
Specifies a maximum number of results that are required (uses the _count search parameter).
This element can be used in combination with the sort element to specify quota requirements such as "the most recent 5" or "the highest 5".
Enables the requirement "most recent 5 results" to be expressed.
Specifies the order of the results to be returned.
This element can be used in combination with the sort element to specify quota requirements such as "the most recent 5" or "the highest 5". When multiple sorts are specified, they are applied in the order they appear in the resource.
The name of the attribute to perform the sort
The attribute of the sort. The specified path must be resolvable from the type of the required data. The path is allowed to contain qualifiers (.) to traverse sub-elements, as well as indexers ([x]) to traverse multiple-cardinality sub-elements. Note that the index must be an integer constant.
The direction of the sort, ascending or descending.
The possible sort directions, ascending or descending.