Da Vinci Risk Adjustment Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-ra/ and changes regularly. See the Directory of published versions

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Resource Profile: Patient Group

The Patient Group Profile describes a group consisting of one or more patients. It can be used a) when generating risk adjustment gap reports using Bulk FHIR or b) for the evaluated-approach for generating reports as defined on the dCC page.

Usage:

• Examples for this Resource Profile: Group/ra-group01 and Group/ra-group02

Formal Views of Profile Content

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

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Group

Name	Flags	Card.	Type	Description & Constraints
Group		0..*	Group	Group of multiple entities
type	S	1..1	code	person | animal | practitioner | device | medication | substance Fixed Value: person
actual	S	1..1	boolean	Descriptive or actual Fixed Value: true
member	S	1..*	BackboneElement	Who is in group
entity	S	1..1	Reference(US Core Patient Profile)	Reference to the patient that is in group
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Group	C	0..*	Group	Group of multiple entities dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management grp-1: Can only have members if group is "actual"
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	SΣ	1..1	code	person | animal | practitioner | device | medication | substance Binding: GroupType (required): Types of resources that are part of group. ele-1: All FHIR elements must have a @value or children Fixed Value: person
actual	SΣC	1..1	boolean	Descriptive or actual ele-1: All FHIR elements must have a @value or children Fixed Value: true
member	SC	1..*	BackboneElement	Who is in group ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
entity	S	1..1	Reference(US Core Patient Profile)	Reference to the patient that is in group ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Group.type	required	Fixed Value: person http://hl7.org/fhir/ValueSet/group-type|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Group	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Group	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	error	Group	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	error	Group	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Group	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
grp-1	error	Group	Can only have members if group is "actual" : member.empty() or (actual = true)

Name	Flags	Card.	Type	Description & Constraints
Group	C	0..*	Group	Group of multiple entities grp-1: Can only have members if group is "actual"
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Unique id
active	Σ	0..1	boolean	Whether this group's record is in active use
type	SΣ	1..1	code	person | animal | practitioner | device | medication | substance Binding: GroupType (required): Types of resources that are part of group. Fixed Value: person
actual	SΣC	1..1	boolean	Descriptive or actual Fixed Value: true
code	Σ	0..1	CodeableConcept	Kind of Group members Binding Description (No ValueSet): (example): Kind of particular resource; e.g. cow, syringe, lake, etc.
name	Σ	0..1	string	Label for Group
quantity	Σ	0..1	unsignedInt	Number of members
managingEntity	Σ	0..1	Reference(Organization | RelatedPerson | Practitioner | PractitionerRole)	Entity that is the custodian of the Group's definition
characteristic		0..*	BackboneElement	Include / Exclude group members by Trait
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	CodeableConcept	Kind of characteristic Binding Description (No ValueSet): (example): List of characteristics used to describe group members; e.g. gender, age, owner, location, etc.
value[x]		1..1		Value held by characteristic Binding Description (No ValueSet): (example): Value of descriptive member characteristic; e.g. red, male, pneumonia, Caucasian, etc.
valueCodeableConcept			CodeableConcept
valueBoolean			boolean
valueQuantity			Quantity
valueRange			Range
valueReference			Reference(Any)
exclude		1..1	boolean	Group includes or excludes
period		0..1	Period	Period over which characteristic is tested
member	SC	1..*	BackboneElement	Who is in group
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
entity	S	1..1	Reference(US Core Patient Profile)	Reference to the patient that is in group
period		0..1	Period	Period member belonged to the group
inactive		0..1	boolean	If member is no longer in group
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Group.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Group.type	required	Fixed Value: person http://hl7.org/fhir/ValueSet/group-type|4.0.1 from the FHIR Standard
Group.code	example
Group.characteristic.code	example
Group.characteristic.value[x]	example

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Group	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Group	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	error	Group	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	error	Group	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Group	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
grp-1	error	Group	Can only have members if group is "actual" : member.empty() or (actual = true)

This structure is derived from Group

Summary

Mandatory: 1 element
Must-Support: 4 elements
Fixed: 2 elements

Structures

This structure refers to these other structures:

• US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)

Maturity: 1

Differential View

This structure is derived from Group

Name	Flags	Card.	Type	Description & Constraints
Group		0..*	Group	Group of multiple entities
type	S	1..1	code	person | animal | practitioner | device | medication | substance Fixed Value: person
actual	S	1..1	boolean	Descriptive or actual Fixed Value: true
member	S	1..*	BackboneElement	Who is in group
entity	S	1..1	Reference(US Core Patient Profile)	Reference to the patient that is in group
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Group	C	0..*	Group	Group of multiple entities dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management grp-1: Can only have members if group is "actual"
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	SΣ	1..1	code	person | animal | practitioner | device | medication | substance Binding: GroupType (required): Types of resources that are part of group. ele-1: All FHIR elements must have a @value or children Fixed Value: person
actual	SΣC	1..1	boolean	Descriptive or actual ele-1: All FHIR elements must have a @value or children Fixed Value: true
member	SC	1..*	BackboneElement	Who is in group ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
entity	S	1..1	Reference(US Core Patient Profile)	Reference to the patient that is in group ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Group.type	required	Fixed Value: person http://hl7.org/fhir/ValueSet/group-type|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Group	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Group	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	error	Group	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	error	Group	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Group	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
grp-1	error	Group	Can only have members if group is "actual" : member.empty() or (actual = true)

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Group	C	0..*	Group	Group of multiple entities grp-1: Can only have members if group is "actual"
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Unique id
active	Σ	0..1	boolean	Whether this group's record is in active use
type	SΣ	1..1	code	person | animal | practitioner | device | medication | substance Binding: GroupType (required): Types of resources that are part of group. Fixed Value: person
actual	SΣC	1..1	boolean	Descriptive or actual Fixed Value: true
code	Σ	0..1	CodeableConcept	Kind of Group members Binding Description (No ValueSet): (example): Kind of particular resource; e.g. cow, syringe, lake, etc.
name	Σ	0..1	string	Label for Group
quantity	Σ	0..1	unsignedInt	Number of members
managingEntity	Σ	0..1	Reference(Organization | RelatedPerson | Practitioner | PractitionerRole)	Entity that is the custodian of the Group's definition
characteristic		0..*	BackboneElement	Include / Exclude group members by Trait
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	CodeableConcept	Kind of characteristic Binding Description (No ValueSet): (example): List of characteristics used to describe group members; e.g. gender, age, owner, location, etc.
value[x]		1..1		Value held by characteristic Binding Description (No ValueSet): (example): Value of descriptive member characteristic; e.g. red, male, pneumonia, Caucasian, etc.
valueCodeableConcept			CodeableConcept
valueBoolean			boolean
valueQuantity			Quantity
valueRange			Range
valueReference			Reference(Any)
exclude		1..1	boolean	Group includes or excludes
period		0..1	Period	Period over which characteristic is tested
member	SC	1..*	BackboneElement	Who is in group
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
entity	S	1..1	Reference(US Core Patient Profile)	Reference to the patient that is in group
period		0..1	Period	Period member belonged to the group
inactive		0..1	boolean	If member is no longer in group
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Group.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Group.type	required	Fixed Value: person http://hl7.org/fhir/ValueSet/group-type|4.0.1 from the FHIR Standard
Group.code	example
Group.characteristic.code	example
Group.characteristic.value[x]	example

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Group	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Group	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	error	Group	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	error	Group	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Group	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
grp-1	error	Group	Can only have members if group is "actual" : member.empty() or (actual = true)

This structure is derived from Group

Summary

Mandatory: 1 element
Must-Support: 4 elements
Fixed: 2 elements

Structures

This structure refers to these other structures:

• US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)

Maturity: 1

Other representations of profile: CSV, Excel, Schematron