FHIR Extensions Pack
5.4.0 - May 2026 International flag

FHIR Extensions Pack, published by HL7 International / FHIR Infrastructure. This guide is not an authorized publication; it is the continuous build for version 5.4.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-extensions/ and changes regularly. See the Directory of published versions

Extension: Protective factor - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 2

Definitions for the workflow-protectiveFactor extension

See the documentation on how to interpret the contents of this table

0. Extension
Definition

Characteristics or strengths of individuals, families, community situations or societies that mitigate risks and promote positive well-being and healthy development; attributes that help to successfully navigate difficult situations; factors that may contribute to or explain positive outcomes. A trait or habit that "protects" people and makes them less likely to get a chronic disease that include, but are not limited to exercise, healthy eating, managing weight, managing blood pressure and cholesterol, managing mental health, feeling happy, strong emotional support and social connections.


Optional Extension Element - found in all resources.

Short ChangedCharacteristics or strengths of individuals, families, community situations or societies that mitigate risks and promote positive well-being and healthy developmentOptional Extensions Element
Comments

The "workflow-" prefix in the name of this extension reflects how it came to be proposed; the extension is not particularly workflow-related, and does not drive event state or actions. (The name has not been changed because that would be a breaking change. The same applies to the workflow-barrier extension.)

This extension is intended for resources that describe prospective care - what is desired or intended to happen - which is why its contexts are plans, goals and requests. It is not appropriate on resources that describe what is happening, such as MedicationStatement.

Control0..*
Is Modifierfalse
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())
2. Extension.extension
Definition

An Extension


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 managable, 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.

ShortExtensionAdditional 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..0*
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())
SlicingThis element introduces a set of slices on Extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url

    • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

    4. Extension.url
    Definition

    Source of the definition for the extension code - a logical name or a URL.

    Shortidentifies the meaning of the extension
    Comments

    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

    Control1..1
    Typeuri
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    Fixed Valuehttp://hl7.org/fhir/StructureDefinition/workflow-protectiveFactor
    6. Extension.value[x]
    Definition

    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

    ShortValue of extension
    Control10..1
    This element is affected by the following invariants: ext-1
    BindingFor example codes, see For codes, see ProtectiveFactor
    (example to http://hl7.org/fhir/ValueSet/protective-factor)
    TypeCodeableReference(Resource), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, RatioRange, Coding, SampledData, id, positiveInt, Distance, Availability, integer64, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ExtendedContactDetail, CodeableConcept, ParameterDefinition, dateTime, code, string, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
    [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()))

    See the documentation on how to interpret the contents of this table

    0. Extension
    Definition

    Changed

    Characteristics or strengths of individuals, families, community situations or societies that mitigate risks and promote positive well-being and healthy development; attributes that help to successfully navigate difficult situations; factors that may contribute to or explain positive outcomes. A trait or habit that "protects" people and makes them less likely to get a chronic disease that include, but are not limited to exercise, healthy eating, managing weight, managing blood pressure and cholesterol, managing mental health, feeling happy, strong emotional support and social connections.

    Short ChangedCharacteristics or strengths of individuals, families, community situations or societies that mitigate risks and promote positive well-being and healthy development
    Comments

    Added

    The "workflow-" prefix in the name of this extension reflects how it came to be proposed; the extension is not particularly workflow-related, and does not drive event state or actions. (The name has not been changed because that would be a breaking change. The same applies to the workflow-barrier extension.)

    This extension is intended for resources that describe prospective care - what is desired or intended to happen - which is why its contexts are plans, goals and requests. It is not appropriate on resources that describe what is happening, such as MedicationStatement.

    Control0..*
    2. Extension.extension
    Control0..0
    4. Extension.url
    Fixed Valuehttp://hl7.org/fhir/StructureDefinition/workflow-protectiveFactor
    6. Extension.value[x]
    Control1..?
    BindingFor example codes, see ProtectiveFactor
    (example to http://hl7.org/fhir/ValueSet/protective-factor)
    TypeCodeableReference(Resource), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, RatioRange, Coding, SampledData, id, positiveInt, Distance, Availability, integer64, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ExtendedContactDetail, CodeableConcept, ParameterDefinition, dateTime, code, string, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]

    See the documentation on how to interpret the contents of this table

    0. Extension
    Definition

    Changed

    Characteristics or strengths of individuals, families, community situations or societies that mitigate risks and promote positive well-being and healthy development; attributes that help to successfully navigate difficult situations; factors that may contribute to or explain positive outcomes. A trait or habit that "protects" people and makes them less likely to get a chronic disease that include, but are not limited to exercise, healthy eating, managing weight, managing blood pressure and cholesterol, managing mental health, feeling happy, strong emotional support and social connections.

    Short ChangedCharacteristics or strengths of individuals, families, community situations or societies that mitigate risks and promote positive well-being and healthy development
    Comments

    Added

    The "workflow-" prefix in the name of this extension reflects how it came to be proposed; the extension is not particularly workflow-related, and does not drive event state or actions. (The name has not been changed because that would be a breaking change. The same applies to the workflow-barrier extension.)

    This extension is intended for resources that describe prospective care - what is desired or intended to happen - which is why its contexts are plans, goals and requests. It is not appropriate on resources that describe what is happening, such as MedicationStatement.

    Control0..*
    Is Modifierfalse
    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())
    2. Extension.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
    This element is affected by the following invariants: ele-1
    Typeid
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    4. Extension.extension
    Definition

    An Extension

    ShortExtension
    Control0..0
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    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())
    SlicingThis element introduces a set of slices on Extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url

      • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

      6. Extension.url
      Definition

      Source of the definition for the extension code - a logical name or a URL.

      Shortidentifies the meaning of the extension
      Comments

      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      Fixed Valuehttp://hl7.org/fhir/StructureDefinition/workflow-protectiveFactor
      8. Extension.value[x]
      Definition

      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      ShortValue of extension
      Control1..1
      This element is affected by the following invariants: ext-1
      BindingFor example codes, see ProtectiveFactor
      (example to http://hl7.org/fhir/ValueSet/protective-factor)
      TypeCodeableReference(Resource)
      [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()))