US Quality Core Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-us-quality-core/ and changes regularly. See the Directory of published versions
| Official URL: http://hl7.org/fhir/us/quality-core/StructureDefinition/us-quality-core-adverseevent | Version: 1.0.0-ballot | ||||
| Standards status: Trial-use | Maturity Level: 4 | Computable Name: USQualityCoreAdverseEvent | |||
| Other Identifiers: OID:2.16.840.1.113883.4.642.40.78.42.1 | |||||
Actual or potential/avoided event causing unintended physical injury resulting from or contributed to by medical care, a research study or other healthcare setting factors that requires additional monitoring, treatment, or hospitalization, or that results in death.
Systems are expected to support this profile as part of implementing USCDI+ Quality V2 in FHIR and meeting the conformance requirements of this guide.
The following elements are specifically relevant to USCDI+ Quality V2 data classes and elements. Systems are expected to support these elements as applicable to their role in US Quality Core data exchange. See the Must Support section of this guide for more information. These elements are flagged as (USCDI+ Quality) in the formal profile views.
USCDI+ Quality Elements:
| Profile element | Description | USCDI+ Quality Data Element(s) |
|---|---|---|
actuality |
actual | potential | Adverse Events: Adverse Event Condition |
date |
When the event occurred | Adverse Events: Adverse Event Condition |
detected |
When the event was detected | Adverse Events: Adverse Event Condition |
event |
Type of the event itself in relation to the subject | Adverse Events: Adverse Event Condition |
outcome |
resolved | recovering | ongoing | resolvedWithSequelae | fatal | unknown | Adverse Events: Adverse Event Outcome |
recordedDate |
When the event was recorded | Adverse Events: Adverse Event Condition |
recorder |
Who recorded the adverse event | Provenance: Author |
subject |
Subject impacted by event | Adverse Events: Adverse Event Condition |
Usages:
You can also check for usages in the FHIR IG Statistics
Description Differentials, Snapshots, and other representations.
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() |
|---|---|---|---|---|
![]() |
0..* | AdverseEvent | Medical care, research study or other healthcare event causing physical injury | |
![]() ![]() |
?!Σ | 0..1 | uri | A set of rules under which this content was created |
![]() ![]() |
?! | 0..* | Extension | Extensions that cannot be ignored |
![]() ![]() |
?!Σ | 1..1 | code | (USCDI+ Quality) actual | potential Binding: AdverseEventActuality (required): Overall nature of the adverse event, e.g. real or potential. |
![]() ![]() |
Σ | 1..1 | CodeableConcept | (USCDI+ Quality) Type of the event itself in relation to the subject Binding: SNOMEDCTClinicalFindings (preferred): Detailed type of event. |
![]() ![]() |
Σ | 1..1 | Reference(US Quality Core Patient) | (USCDI+ Quality) Subject impacted by event |
![]() ![]() |
Σ | 0..1 | Reference(US Quality Core Encounter) | Encounter created as part of |
![]() ![]() |
Σ | 0..1 | dateTime | (USCDI+ Quality) When the event occurred |
![]() ![]() |
Σ | 0..1 | dateTime | (USCDI+ Quality) When the event was detected |
![]() ![]() |
Σ | 0..1 | dateTime | (USCDI+ Quality) When the event was recorded |
![]() ![]() |
Σ | 0..* | Reference(US Quality Core Condition Problems Health Concerns | US Quality Core Condition Encounter Diagnosis) | Effect on the subject due to this event |
![]() ![]() |
Σ | 0..1 | Reference(US Quality Core Location) | Location where adverse event occurred |
![]() ![]() |
Σ | 0..1 | CodeableConcept | mild | moderate | severe Binding: AdverseEventSeverity (required): The severity of the adverse event itself, in direct relation to the subject. |
![]() ![]() |
Σ | 0..1 | CodeableConcept | (USCDI+ Quality) resolved | recovering | ongoing | resolvedWithSequelae | fatal | unknown Binding: AdverseEventOutcome (required): Type of outcome from the adverse event |
![]() ![]() |
Σ | 0..1 | Reference(US Quality Core Patient | US Quality Core RelatedPerson | US Quality Core Practitioner | US Quality Core PractitionerRole) | (USCDI+ Quality) Who recorded the adverse event |
![]() ![]() |
Σ | 0..* | Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Core Device Profile(9.0.0)) | Who was involved in the adverse event or the potential adverse event |
![]() ![]() |
Σ | 0..* | BackboneElement | The suspected agent causing the adverse event |
![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() |
Σ | 1..1 | Reference(US Quality Core Immunization | US Quality Core Procedure | Substance | US Quality Core Medication | US Quality Core MedicationAdministration | MedicationStatement | US Core Device Profile(9.0.0)) | Refers to the specific entity that caused the adverse event |
![]() ![]() ![]() |
Σ | 0..* | BackboneElement | Information on the possible cause of the event |
![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() ![]() |
Σ | 0..1 | CodeableConcept | ProbabilityScale | Bayesian | Checklist Binding: AdverseEventCausalityMethod (example): Method used to assess event causality |
![]() ![]() |
Σ | 0..* | Reference(US Quality Core Simple Observation | US Quality Core AllergyIntolerance | US Core FamilyMemberHistory Profile(9.0.0) | US Quality Core Immunization | US Quality Core Procedure | US Quality Core Condition Problems Health Concerns | US Quality Core Condition Encounter Diagnosis) | AdverseEvent.subjectMedicalHistory |
Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| AdverseEvent.actuality | Base | required | AdverseEventActuality | 📍4.0.1 | FHIR Std. |
| AdverseEvent.event | Base | preferred | SNOMED CT Clinical Findings | 📦4.0.1 | FHIR Std. |
| AdverseEvent.severity | Base | required | AdverseEventSeverity | 📦4.0.1 | FHIR Std. |
| AdverseEvent.outcome | Base | required | AdverseEventOutcome | 📍4.0.1 | FHIR Std. |
| AdverseEvent.suspectEntity.causality.method | Base | example | AdverseEventCausalityMethod | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | AdverseEvent | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | AdverseEvent | 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 | AdverseEvent | 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 | AdverseEvent | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | AdverseEvent | 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()
|
| Path | Status | Usage | ValueSet | Version | Source |
| AdverseEvent.event | Base | preferred | SNOMED CT Clinical Findings | 📦4.0.1 | FHIR Std. |
| AdverseEvent.severity | Base | required | AdverseEventSeverity | 📦4.0.1 | FHIR Std. |
| AdverseEvent.outcome | Base | required | AdverseEventOutcome | 📍4.0.1 | FHIR Std. |
| AdverseEvent.suspectEntity.causality.method | Base | example | AdverseEventCausalityMethod | 📍4.0.1 | FHIR Std. |
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() | ||||
|---|---|---|---|---|---|---|---|---|
![]() |
0..* | AdverseEvent | Medical care, research study or other healthcare event causing physical injury | |||||
![]() ![]() |
Σ | 0..1 | id | Logical id of this artifact | ||||
![]() ![]() |
Σ | 0..1 | Meta | Metadata about the resource | ||||
![]() ![]() |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
![]() ![]() |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
![]() ![]() |
0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
![]() ![]() |
0..* | Resource | Contained, inline Resources | |||||
![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||
![]() ![]() |
Σ | 0..1 | Identifier | Business identifier for the event | ||||
![]() ![]() |
?!Σ | 1..1 | code | (USCDI+ Quality) actual | potential Binding: AdverseEventActuality (required): Overall nature of the adverse event, e.g. real or potential. | ||||
![]() ![]() |
Σ | 0..* | CodeableConcept | product-problem | product-quality | product-use-error | wrong-dose | incorrect-prescribing-information | wrong-technique | wrong-route-of-administration | wrong-rate | wrong-duration | wrong-time | expired-drug | medical-device-use-error | problem-different-manufacturer | unsafe-physical-environment Binding: AdverseEventCategory (extensible): Overall categorization of the event, e.g. product-related or situational. | ||||
![]() ![]() |
Σ | 1..1 | CodeableConcept | (USCDI+ Quality) Type of the event itself in relation to the subject Binding: SNOMEDCTClinicalFindings (preferred): Detailed type of event. | ||||
![]() ![]() |
Σ | 1..1 | Reference(US Quality Core Patient) | (USCDI+ Quality) Subject impacted by event | ||||
![]() ![]() |
Σ | 0..1 | Reference(US Quality Core Encounter) | Encounter created as part of | ||||
![]() ![]() |
Σ | 0..1 | dateTime | (USCDI+ Quality) When the event occurred | ||||
![]() ![]() |
Σ | 0..1 | dateTime | (USCDI+ Quality) When the event was detected | ||||
![]() ![]() |
Σ | 0..1 | dateTime | (USCDI+ Quality) When the event was recorded | ||||
![]() ![]() |
Σ | 0..* | Reference(US Quality Core Condition Problems Health Concerns | US Quality Core Condition Encounter Diagnosis) | Effect on the subject due to this event | ||||
![]() ![]() |
Σ | 0..1 | Reference(US Quality Core Location) | Location where adverse event occurred | ||||
![]() ![]() |
Σ | 0..1 | CodeableConcept | Seriousness of the event Binding: AdverseEventSeriousness (example): Overall seriousness of this event for the patient. | ||||
![]() ![]() |
Σ | 0..1 | CodeableConcept | mild | moderate | severe Binding: AdverseEventSeverity (required): The severity of the adverse event itself, in direct relation to the subject. | ||||
![]() ![]() |
Σ | 0..1 | CodeableConcept | (USCDI+ Quality) resolved | recovering | ongoing | resolvedWithSequelae | fatal | unknown Binding: AdverseEventOutcome (required): Type of outcome from the adverse event | ||||
![]() ![]() |
Σ | 0..1 | Reference(US Quality Core Patient | US Quality Core RelatedPerson | US Quality Core Practitioner | US Quality Core PractitionerRole) | (USCDI+ Quality) Who recorded the adverse event | ||||
![]() ![]() |
Σ | 0..* | Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Core Device Profile(9.0.0)) | Who was involved in the adverse event or the potential adverse event | ||||
![]() ![]() |
Σ | 0..* | BackboneElement | The suspected agent causing the adverse event | ||||
![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() |
Σ | 1..1 | Reference(US Quality Core Immunization | US Quality Core Procedure | Substance | US Quality Core Medication | US Quality Core MedicationAdministration | MedicationStatement | US Core Device Profile(9.0.0)) | Refers to the specific entity that caused the adverse event | ||||
![]() ![]() ![]() |
Σ | 0..* | BackboneElement | Information on the possible cause of the event | ||||
![]() ![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() |
Σ | 0..1 | CodeableConcept | Assessment of if the entity caused the event Binding: AdverseEventCausalityAssessment (example): Codes for the assessment of whether the entity caused the event. | ||||
![]() ![]() ![]() ![]() |
Σ | 0..1 | string | AdverseEvent.suspectEntity.causalityProductRelatedness | ||||
![]() ![]() ![]() ![]() |
Σ | 0..1 | Reference(Practitioner | PractitionerRole) | AdverseEvent.suspectEntity.causalityAuthor | ||||
![]() ![]() ![]() ![]() |
Σ | 0..1 | CodeableConcept | ProbabilityScale | Bayesian | Checklist Binding: AdverseEventCausalityMethod (example): Method used to assess event causality | ||||
![]() ![]() |
Σ | 0..* | Reference(US Quality Core Simple Observation | US Quality Core AllergyIntolerance | US Core FamilyMemberHistory Profile(9.0.0) | US Quality Core Immunization | US Quality Core Procedure | US Quality Core Condition Problems Health Concerns | US Quality Core Condition Encounter Diagnosis) | AdverseEvent.subjectMedicalHistory | ||||
![]() ![]() |
Σ | 0..* | Reference(DocumentReference) | AdverseEvent.referenceDocument | ||||
![]() ![]() |
Σ | 0..* | Reference(ResearchStudy) | AdverseEvent.study | ||||
Documentation for this format | ||||||||
| Path | Status | Usage | ValueSet | Version | Source |
| AdverseEvent.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std. |
| AdverseEvent.actuality | Base | required | AdverseEventActuality | 📍4.0.1 | FHIR Std. |
| AdverseEvent.category | Base | extensible | AdverseEventCategory | 📍4.0.1 | FHIR Std. |
| AdverseEvent.event | Base | preferred | SNOMED CT Clinical Findings | 📦4.0.1 | FHIR Std. |
| AdverseEvent.seriousness | Base | example | AdverseEventSeriousness | 📍4.0.1 | FHIR Std. |
| AdverseEvent.severity | Base | required | AdverseEventSeverity | 📦4.0.1 | FHIR Std. |
| AdverseEvent.outcome | Base | required | AdverseEventOutcome | 📍4.0.1 | FHIR Std. |
| AdverseEvent.suspectEntity.causality.assessment | Base | example | AdverseEventCausalityAssessment | 📍4.0.1 | FHIR Std. |
| AdverseEvent.suspectEntity.causality.method | Base | example | AdverseEventCausalityMethod | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | AdverseEvent | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | AdverseEvent | 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 | AdverseEvent | 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 | AdverseEvent | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | AdverseEvent | 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()
|
Summary
Mandatory: 1 element
Structures
This structure refers to these other structures:
Maturity: 4
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() |
|---|---|---|---|---|
![]() |
0..* | AdverseEvent | Medical care, research study or other healthcare event causing physical injury | |
![]() ![]() |
?!Σ | 0..1 | uri | A set of rules under which this content was created |
![]() ![]() |
?! | 0..* | Extension | Extensions that cannot be ignored |
![]() ![]() |
?!Σ | 1..1 | code | (USCDI+ Quality) actual | potential Binding: AdverseEventActuality (required): Overall nature of the adverse event, e.g. real or potential. |
![]() ![]() |
Σ | 1..1 | CodeableConcept | (USCDI+ Quality) Type of the event itself in relation to the subject Binding: SNOMEDCTClinicalFindings (preferred): Detailed type of event. |
![]() ![]() |
Σ | 1..1 | Reference(US Quality Core Patient) | (USCDI+ Quality) Subject impacted by event |
![]() ![]() |
Σ | 0..1 | Reference(US Quality Core Encounter) | Encounter created as part of |
![]() ![]() |
Σ | 0..1 | dateTime | (USCDI+ Quality) When the event occurred |
![]() ![]() |
Σ | 0..1 | dateTime | (USCDI+ Quality) When the event was detected |
![]() ![]() |
Σ | 0..1 | dateTime | (USCDI+ Quality) When the event was recorded |
![]() ![]() |
Σ | 0..* | Reference(US Quality Core Condition Problems Health Concerns | US Quality Core Condition Encounter Diagnosis) | Effect on the subject due to this event |
![]() ![]() |
Σ | 0..1 | Reference(US Quality Core Location) | Location where adverse event occurred |
![]() ![]() |
Σ | 0..1 | CodeableConcept | mild | moderate | severe Binding: AdverseEventSeverity (required): The severity of the adverse event itself, in direct relation to the subject. |
![]() ![]() |
Σ | 0..1 | CodeableConcept | (USCDI+ Quality) resolved | recovering | ongoing | resolvedWithSequelae | fatal | unknown Binding: AdverseEventOutcome (required): Type of outcome from the adverse event |
![]() ![]() |
Σ | 0..1 | Reference(US Quality Core Patient | US Quality Core RelatedPerson | US Quality Core Practitioner | US Quality Core PractitionerRole) | (USCDI+ Quality) Who recorded the adverse event |
![]() ![]() |
Σ | 0..* | Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Core Device Profile(9.0.0)) | Who was involved in the adverse event or the potential adverse event |
![]() ![]() |
Σ | 0..* | BackboneElement | The suspected agent causing the adverse event |
![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() |
Σ | 1..1 | Reference(US Quality Core Immunization | US Quality Core Procedure | Substance | US Quality Core Medication | US Quality Core MedicationAdministration | MedicationStatement | US Core Device Profile(9.0.0)) | Refers to the specific entity that caused the adverse event |
![]() ![]() ![]() |
Σ | 0..* | BackboneElement | Information on the possible cause of the event |
![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() ![]() |
Σ | 0..1 | CodeableConcept | ProbabilityScale | Bayesian | Checklist Binding: AdverseEventCausalityMethod (example): Method used to assess event causality |
![]() ![]() |
Σ | 0..* | Reference(US Quality Core Simple Observation | US Quality Core AllergyIntolerance | US Core FamilyMemberHistory Profile(9.0.0) | US Quality Core Immunization | US Quality Core Procedure | US Quality Core Condition Problems Health Concerns | US Quality Core Condition Encounter Diagnosis) | AdverseEvent.subjectMedicalHistory |
Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| AdverseEvent.actuality | Base | required | AdverseEventActuality | 📍4.0.1 | FHIR Std. |
| AdverseEvent.event | Base | preferred | SNOMED CT Clinical Findings | 📦4.0.1 | FHIR Std. |
| AdverseEvent.severity | Base | required | AdverseEventSeverity | 📦4.0.1 | FHIR Std. |
| AdverseEvent.outcome | Base | required | AdverseEventOutcome | 📍4.0.1 | FHIR Std. |
| AdverseEvent.suspectEntity.causality.method | Base | example | AdverseEventCausalityMethod | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | AdverseEvent | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | AdverseEvent | 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 | AdverseEvent | 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 | AdverseEvent | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | AdverseEvent | 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()
|
Differential View
| Path | Status | Usage | ValueSet | Version | Source |
| AdverseEvent.event | Base | preferred | SNOMED CT Clinical Findings | 📦4.0.1 | FHIR Std. |
| AdverseEvent.severity | Base | required | AdverseEventSeverity | 📦4.0.1 | FHIR Std. |
| AdverseEvent.outcome | Base | required | AdverseEventOutcome | 📍4.0.1 | FHIR Std. |
| AdverseEvent.suspectEntity.causality.method | Base | example | AdverseEventCausalityMethod | 📍4.0.1 | FHIR Std. |
Snapshot ViewView
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() | ||||
|---|---|---|---|---|---|---|---|---|
![]() |
0..* | AdverseEvent | Medical care, research study or other healthcare event causing physical injury | |||||
![]() ![]() |
Σ | 0..1 | id | Logical id of this artifact | ||||
![]() ![]() |
Σ | 0..1 | Meta | Metadata about the resource | ||||
![]() ![]() |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
![]() ![]() |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
![]() ![]() |
0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
![]() ![]() |
0..* | Resource | Contained, inline Resources | |||||
![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||
![]() ![]() |
Σ | 0..1 | Identifier | Business identifier for the event | ||||
![]() ![]() |
?!Σ | 1..1 | code | (USCDI+ Quality) actual | potential Binding: AdverseEventActuality (required): Overall nature of the adverse event, e.g. real or potential. | ||||
![]() ![]() |
Σ | 0..* | CodeableConcept | product-problem | product-quality | product-use-error | wrong-dose | incorrect-prescribing-information | wrong-technique | wrong-route-of-administration | wrong-rate | wrong-duration | wrong-time | expired-drug | medical-device-use-error | problem-different-manufacturer | unsafe-physical-environment Binding: AdverseEventCategory (extensible): Overall categorization of the event, e.g. product-related or situational. | ||||
![]() ![]() |
Σ | 1..1 | CodeableConcept | (USCDI+ Quality) Type of the event itself in relation to the subject Binding: SNOMEDCTClinicalFindings (preferred): Detailed type of event. | ||||
![]() ![]() |
Σ | 1..1 | Reference(US Quality Core Patient) | (USCDI+ Quality) Subject impacted by event | ||||
![]() ![]() |
Σ | 0..1 | Reference(US Quality Core Encounter) | Encounter created as part of | ||||
![]() ![]() |
Σ | 0..1 | dateTime | (USCDI+ Quality) When the event occurred | ||||
![]() ![]() |
Σ | 0..1 | dateTime | (USCDI+ Quality) When the event was detected | ||||
![]() ![]() |
Σ | 0..1 | dateTime | (USCDI+ Quality) When the event was recorded | ||||
![]() ![]() |
Σ | 0..* | Reference(US Quality Core Condition Problems Health Concerns | US Quality Core Condition Encounter Diagnosis) | Effect on the subject due to this event | ||||
![]() ![]() |
Σ | 0..1 | Reference(US Quality Core Location) | Location where adverse event occurred | ||||
![]() ![]() |
Σ | 0..1 | CodeableConcept | Seriousness of the event Binding: AdverseEventSeriousness (example): Overall seriousness of this event for the patient. | ||||
![]() ![]() |
Σ | 0..1 | CodeableConcept | mild | moderate | severe Binding: AdverseEventSeverity (required): The severity of the adverse event itself, in direct relation to the subject. | ||||
![]() ![]() |
Σ | 0..1 | CodeableConcept | (USCDI+ Quality) resolved | recovering | ongoing | resolvedWithSequelae | fatal | unknown Binding: AdverseEventOutcome (required): Type of outcome from the adverse event | ||||
![]() ![]() |
Σ | 0..1 | Reference(US Quality Core Patient | US Quality Core RelatedPerson | US Quality Core Practitioner | US Quality Core PractitionerRole) | (USCDI+ Quality) Who recorded the adverse event | ||||
![]() ![]() |
Σ | 0..* | Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Core Device Profile(9.0.0)) | Who was involved in the adverse event or the potential adverse event | ||||
![]() ![]() |
Σ | 0..* | BackboneElement | The suspected agent causing the adverse event | ||||
![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() |
Σ | 1..1 | Reference(US Quality Core Immunization | US Quality Core Procedure | Substance | US Quality Core Medication | US Quality Core MedicationAdministration | MedicationStatement | US Core Device Profile(9.0.0)) | Refers to the specific entity that caused the adverse event | ||||
![]() ![]() ![]() |
Σ | 0..* | BackboneElement | Information on the possible cause of the event | ||||
![]() ![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() |
Σ | 0..1 | CodeableConcept | Assessment of if the entity caused the event Binding: AdverseEventCausalityAssessment (example): Codes for the assessment of whether the entity caused the event. | ||||
![]() ![]() ![]() ![]() |
Σ | 0..1 | string | AdverseEvent.suspectEntity.causalityProductRelatedness | ||||
![]() ![]() ![]() ![]() |
Σ | 0..1 | Reference(Practitioner | PractitionerRole) | AdverseEvent.suspectEntity.causalityAuthor | ||||
![]() ![]() ![]() ![]() |
Σ | 0..1 | CodeableConcept | ProbabilityScale | Bayesian | Checklist Binding: AdverseEventCausalityMethod (example): Method used to assess event causality | ||||
![]() ![]() |
Σ | 0..* | Reference(US Quality Core Simple Observation | US Quality Core AllergyIntolerance | US Core FamilyMemberHistory Profile(9.0.0) | US Quality Core Immunization | US Quality Core Procedure | US Quality Core Condition Problems Health Concerns | US Quality Core Condition Encounter Diagnosis) | AdverseEvent.subjectMedicalHistory | ||||
![]() ![]() |
Σ | 0..* | Reference(DocumentReference) | AdverseEvent.referenceDocument | ||||
![]() ![]() |
Σ | 0..* | Reference(ResearchStudy) | AdverseEvent.study | ||||
Documentation for this format | ||||||||
| Path | Status | Usage | ValueSet | Version | Source |
| AdverseEvent.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std. |
| AdverseEvent.actuality | Base | required | AdverseEventActuality | 📍4.0.1 | FHIR Std. |
| AdverseEvent.category | Base | extensible | AdverseEventCategory | 📍4.0.1 | FHIR Std. |
| AdverseEvent.event | Base | preferred | SNOMED CT Clinical Findings | 📦4.0.1 | FHIR Std. |
| AdverseEvent.seriousness | Base | example | AdverseEventSeriousness | 📍4.0.1 | FHIR Std. |
| AdverseEvent.severity | Base | required | AdverseEventSeverity | 📦4.0.1 | FHIR Std. |
| AdverseEvent.outcome | Base | required | AdverseEventOutcome | 📍4.0.1 | FHIR Std. |
| AdverseEvent.suspectEntity.causality.assessment | Base | example | AdverseEventCausalityAssessment | 📍4.0.1 | FHIR Std. |
| AdverseEvent.suspectEntity.causality.method | Base | example | AdverseEventCausalityMethod | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | AdverseEvent | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | AdverseEvent | 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 | AdverseEvent | 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 | AdverseEvent | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | AdverseEvent | 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()
|
Summary
Mandatory: 1 element
Structures
This structure refers to these other structures:
Maturity: 4
Other representations of profile: CSV, Excel, Schematron
Badges identify the profile layer where each conformance indicator is first introduced. Indicators introduced in an earlier layer remain applicable in later derived profiles.
| Profile element | FHIR | US Quality Core |
|---|---|---|
actuality |
Mandatory | USCDI+ Quality |
event |
Mandatory USCDI+ Quality | |
subject |
Mandatory | USCDI+ Quality |
date |
USCDI+ Quality | |
detected |
USCDI+ Quality | |
recordedDate |
USCDI+ Quality | |
outcome |
USCDI+ Quality | |
recorder |
USCDI+ Quality | |
suspectEntity.instance |
Mandatory |
Cardinality note: “Mandatory” means the element has a minimum cardinality greater than zero. For nested elements, the cardinality indicator applies when the containing element is present.
The searches below are the focused set identified by US Quality Core as needed to retrieve USCDI+ Quality data for quality measurement and reporting. See the US Core FHIR RESTful Search API Requirements for detailed information on requirements by search parameter type.
See the US Quality Core Server CapabilityStatement for complete requirements for the underlying AdverseEvent resource and Search Requirement Selection for how this focused set was selected.
Servers supporting this profile SHALL support the following search parameters and search parameter combinations:
SHALL support searching for all AdverseEvent resources for a patient using the subject search parameter.
GET [base]/AdverseEvent?subject={Patient/}[id]
Example:
GET [base]/AdverseEvent?subject=Patient/example
Implementation Notes: Fetches a bundle of US Quality Core AdverseEvent resources matching the specified search criteria. See how to search by reference.
Rationale for inclusion: Supports subject-scoped retrieval of AdverseEvent resources for USCDI+ Quality workflows.
SHALL support searching for all AdverseEvent resources for a patient using the combination of the subject and event search parameters.
event (e.g.event={system|}[search_code],{system|}[search_code],...).GET [base]/AdverseEvent?subject={Patient/}[id]&event={system|}[search_code]
Example:
GET [base]/AdverseEvent?subject=Patient/example&event=http://snomed.info/sct|725119006
Implementation Notes: Fetches a bundle of US Quality Core AdverseEvent resources matching the specified search criteria. See how to search by reference and how to search by token.
Rationale for inclusion: Supports subject-scoped retrieval of AdverseEvent resources filtered by event for USCDI+ Quality workflows.
SHALL support searching for all AdverseEvent resources for a patient using the combination of the subject and recorded-date search parameters.
Including optional support for AND search on recorded-date (e.g.recorded-date=[date]&recorded-date=[date]&...).
Including support for these recorded-date comparators: "gt", "lt", "ge", "le".
GET [base]/AdverseEvent?subject={Patient/}[id]&recorded-date={gt|lt|ge|le}[dateTime]
Example:
GET [base]/AdverseEvent?subject=Patient/example&recorded-date=ge2020-01-01T00:00:00Z
Implementation Notes: Fetches a bundle of US Quality Core AdverseEvent resources matching the specified search criteria. See how to search by reference and how to search by date.
Rationale for inclusion: Supports subject-scoped retrieval of AdverseEvent resources filtered by recorded date so quality workflows can constrain results to relevant reporting periods.