OO Incubator Implementation Guide
0.1.0 - ci-build International flag

OO Incubator Implementation Guide, published by HL7 International / Orders and Observations. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/oo-incubator/ and changes regularly. See the Directory of published versions

Resource: DeviceUsage - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 1

Definitions for the DeviceUsage resource

Guidance on how to interpret the contents of this table can be foundhere

0. DeviceUsage
Definition

A record of a device being used by a patient where the record is the result of a report from the patient or a clinician.


A resource that includes narrative, extensions, and contained resources.

ShortRecord of use of a deviceA resource with narrative, extensions, and contained resources
Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsdom-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.trace('id') in %resource.descendants().select(reference | as(uri))) or descendants().where(reference='#' | as(uri)='#').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())
2. DeviceUsage.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

ShortLogical id of this artifact
Comments

Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

Control0..1
Typeid
Is Modifierfalse
Must Supportfalse
Summarytrue
4. DeviceUsage.meta
Definition

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.

ShortMetadata about the resource
Control0..1
TypeMeta
Is Modifierfalse
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. DeviceUsage.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 its 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 its meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. DeviceUsage.language
Definition

The base language in which the resource is written.

ShortLanguage of the resource content
Comments

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).

Control0..1
BindingThe codes SHALL be taken from AllLanguageshttp://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot3
(required to http://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot3)

IETF language tag for a human language

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. DeviceUsage.text
Definition

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.

ShortText summary of the resource, for human interpretation
Comments

Contained resources do not have a 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.

Control0..1
This element is affected by the following invariants: dom-6
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesnarrative, html, xhtml, display
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. DeviceUsage.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

ShortContained, inline Resources
Comments

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. Contained resources may be a resource type defined in the FHIR specification, or an additional resource.

Control0..*
This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
TypeResource
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
14. DeviceUsage.extension
Definition

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 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.

ShortAdditional 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..*
TypeExtension
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on DeviceUsage.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 16. DeviceUsage.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 managable, 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
    Must Supportfalse
    Summarytrue
    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()))
    SlicingThis element introduces a set of slices on DeviceUsage.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 18. DeviceUsage.identifier
      Definition

      An external identifier for this statement such as an IRI.

      ShortExternal identifier for this record
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      Summarytrue
      20. DeviceUsage.basedOn
      Definition

      A plan, proposal or order that is fulfilled in whole or in part by this DeviceUsage.

      ShortFulfills plan, proposal or order
      Control0..*
      TypeReference(ServiceRequest)
      Summarytrue
      Requirements

      Allows tracing of authorization for the DeviceUsage and tracking whether proposals/recommendations were acted upon.

      Alternate Namesfulfills
      22. DeviceUsage.partOf
      Definition

      A larger event of which this particular device usage is one part the usage.

      ShortPart of referenced device usage
      Control0..*
      TypeReference(DeviceUsage)
      Summarytrue
      24. DeviceUsage.status
      Definition

      The current state of the device usage.

      Shortpreparation | active | completed | not-done | entered-in-error +
      Comments

      DeviceUsage is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for contains codes that assert the status of the use by the patient (for example, stopped or on hold) as well as codes that assert the status of the resource itself (for example, entered in error).

      This element is labeled as a modifier because the status contains the codes that mark the statement as not currently valid. When the status is 'not-done', the event-statusReason extension should be used to indicate why the DeviceUsage was not done.

      Control1..1
      BindingThe codes SHALL be taken from DeviceUsageStatushttp://hl7.org/fhir/ValueSet/deviceusage-status
      (required to http://hl7.org/fhir/ValueSet/deviceusage-status)

      A coded concept indicating the current status of the Device Usage.

      Typecode
      Is Modifiertrue because 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
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      26. DeviceUsage.category
      Definition

      This attribute indicates a category for the statement - The device statement may be made in an inpatient or outpatient settting (inpatient | outpatient | community | patientspecified).

      ShortThe category of the statement - classifying how the statement is made
      Control0..*
      TypeCodeableConcept
      28. DeviceUsage.subject
      Definition

      The individual(s) who used the device.

      ShortIndividuals(s) who used the device
      Comments

      Group is only allowed in the circumstance where the group represents a family or a household, and should not represent groups of Practitioners where other more specific resources can be used instead.

      Control1..1
      TypeReference(Patient, Group)
      Summarytrue
      30. DeviceUsage.derivedFrom
      Definition

      Allows linking the DeviceUsage to the underlying Request, or to other information that supports or is used to derive the DeviceUsage.

      ShortSupporting information
      Comments

      The most common use cases for deriving a DeviceUsage comes from creating it from a request or from an observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the DeviceUsage from.

      Control0..*
      TypeReference(ServiceRequest, Procedure, Claim, Observation, QuestionnaireResponse, DocumentReference)
      Summarytrue
      32. DeviceUsage.context
      Definition

      The encounter or episode of care that establishes the context for this device use statement.

      ShortThe encounter or episode of care that establishes the context for this device use statement
      Control0..1
      TypeReference(Encounter, EpisodeOfCare)
      Summarytrue
      34. DeviceUsage.timing[x]
      Definition

      How often the device was used.

      ShortHow often the device was used
      Control0..1
      TypeChoice of: Timing, Period, dateTime
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      36. DeviceUsage.dateAsserted
      Definition

      The time at which the statement was recorded by informationSource.

      ShortWhen the statement was made (and recorded)
      Control0..1
      TypedateTime
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      38. DeviceUsage.usageStatus
      Definition

      The status of the device usage, for example always, sometimes, never. This is not the same as the status of the statement.

      ShortThe status of the device usage, for example always, sometimes, never. This is not the same as the status of the statement
      Control0..1
      BindingThe codes SHALL be taken from DeviceUsageStatushttp://hl7.org/fhir/ValueSet/deviceusage-status
      (required to http://hl7.org/fhir/ValueSet/deviceusage-status)

      Codes representing the usage status of the device.

      TypeCodeableConcept
      40. DeviceUsage.usageReason
      Definition

      The reason for asserting the usage status - for example forgot, lost, stolen, broken.

      ShortThe reason for asserting the usage status - for example forgot, lost, stolen, broken
      Control0..*
      TypeCodeableConcept
      42. DeviceUsage.adherence
      Definition

      This indicates how or if the device is being used.

      ShortHow device is being used
      Control0..1
      TypeBackboneElement
      Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
      44. DeviceUsage.adherence.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
      Typeidstring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      46. DeviceUsage.adherence.extension
      Definition

      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.

      ShortAdditional 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..*
      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()))
      SlicingThis element introduces a set of slices on DeviceUsage.adherence.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 48. DeviceUsage.adherence.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 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. 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 even if unrecognized
        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 element that contains them
        Summarytrue
        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, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. DeviceUsage.adherence.code
        Definition

        Type of adherence.

        Shortalways | never | sometimes
        Control1..1
        BindingFor example codes, see DeviceUsageAdherenceCodehttp://hl7.org/fhir/ValueSet/deviceusage-adherence-code
        (example to http://hl7.org/fhir/ValueSet/deviceusage-adherence-code)

        Codes for adherence

        TypeCodeableConcept
        52. DeviceUsage.adherence.reason
        Definition

        Reason for adherence type.

        Shortlost | stolen | prescribed | broken | burned | forgot
        Control1..*
        BindingFor example codes, see DeviceUsageAdherenceReasonhttp://hl7.org/fhir/ValueSet/deviceusage-adherence-reason
        (example to http://hl7.org/fhir/ValueSet/deviceusage-adherence-reason)

        Codes for adherence reason

        TypeCodeableConcept
        54. DeviceUsage.informationSource
        Definition

        Who reported the device was being used by the patient.

        ShortWho made the statement
        Comments

        Group is only allowed in the circumstance where the group represents a family or a household, and should not represent groups of Practitioners where other more specific resources can be used instead.

        Control0..1
        TypeReference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization, Group)
        Summarytrue
        56. DeviceUsage.device
        Definition

        Code or Reference to device used.

        ShortCode or Reference to device used
        Control1..1
        TypeCodeableReference(Device, DeviceDefinition)
        Summarytrue
        58. DeviceUsage.reason
        Definition

        Reason or justification for the use of the device. A coded concept, or another resource whose existence justifies this DeviceUsage.

        ShortWhy device was used
        Comments

        When the status is not done, the reason code indicates why it was not done.

        Control0..*
        TypeCodeableReference(Condition, Observation, DiagnosticReport, DocumentReference, Procedure)
        Summarytrue
        60. DeviceUsage.bodyStructure
        Definition

        Indicates the anatomic location on the subject's body where the device was used (i.e. the target).

        ShortTarget body structure
        Control0..1
        BindingFor example codes, see SNOMEDCTBodyStructureshttp://hl7.org/fhir/ValueSet/body-site
        (example to http://hl7.org/fhir/ValueSet/body-site)

        SNOMED CT Body Structures

        TypeCodeableReference(BodyStructure)
        Summarytrue
        Requirements

        Knowing where the device is targeted is important for tracking if multiple sites are possible. If more information than just a code is required, use the extension BodyStructure Reference.

        62. DeviceUsage.note
        Definition

        Details about the device statement that were not represented at all or sufficiently in one of the attributes provided in a class. These may include for example a comment, an instruction, or a note associated with the statement.

        ShortAddition details (comments, instructions)
        Control0..*
        TypeAnnotation

        Guidance on how to interpret the contents of this table can be foundhere

        0. DeviceUsage
        Definition

        A record of a device being used by a patient where the record is the result of a report from the patient or a clinician.

        ShortRecord of use of a device
        Control0..*
        2. DeviceUsage.identifier
        Definition

        An external identifier for this statement such as an IRI.

        ShortExternal identifier for this record
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        TypeIdentifier
        4. DeviceUsage.basedOn
        Definition

        A plan, proposal or order that is fulfilled in whole or in part by this DeviceUsage.

        ShortFulfills plan, proposal or order
        Control0..*
        TypeReference(ServiceRequest)
        Requirements

        Allows tracing of authorization for the DeviceUsage and tracking whether proposals/recommendations were acted upon.

        Alternate Namesfulfills
        6. DeviceUsage.partOf
        Definition

        A larger event of which this particular device usage is one part the usage.

        ShortPart of referenced device usage
        Control0..*
        TypeReference(DeviceUsage)
        8. DeviceUsage.status
        Definition

        The current state of the device usage.

        Shortpreparation | active | completed | not-done | entered-in-error +
        Comments

        DeviceUsage is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for contains codes that assert the status of the use by the patient (for example, stopped or on hold) as well as codes that assert the status of the resource itself (for example, entered in error).

        This element is labeled as a modifier because the status contains the codes that mark the statement as not currently valid. When the status is 'not-done', the event-statusReason extension should be used to indicate why the DeviceUsage was not done.

        Control1..1
        BindingThe codes SHALL be taken from DeviceUsageStatus
        (required to http://hl7.org/fhir/ValueSet/deviceusage-status)

        A coded concept indicating the current status of the Device Usage.

        Typecode
        Is Modifiertrue because 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
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        10. DeviceUsage.category
        Definition

        This attribute indicates a category for the statement - The device statement may be made in an inpatient or outpatient settting (inpatient | outpatient | community | patientspecified).

        ShortThe category of the statement - classifying how the statement is made
        Control0..*
        TypeCodeableConcept
        12. DeviceUsage.subject
        Definition

        The individual(s) who used the device.

        ShortIndividuals(s) who used the device
        Comments

        Group is only allowed in the circumstance where the group represents a family or a household, and should not represent groups of Practitioners where other more specific resources can be used instead.

        Control1..1
        TypeReference(Patient, Group)
        14. DeviceUsage.derivedFrom
        Definition

        Allows linking the DeviceUsage to the underlying Request, or to other information that supports or is used to derive the DeviceUsage.

        ShortSupporting information
        Comments

        The most common use cases for deriving a DeviceUsage comes from creating it from a request or from an observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the DeviceUsage from.

        Control0..*
        TypeReference(ServiceRequest, Procedure, Claim, Observation, QuestionnaireResponse, DocumentReference)
        16. DeviceUsage.context
        Definition

        The encounter or episode of care that establishes the context for this device use statement.

        ShortThe encounter or episode of care that establishes the context for this device use statement
        Control0..1
        TypeReference(Encounter, EpisodeOfCare)
        18. DeviceUsage.timing[x]
        Definition

        How often the device was used.

        ShortHow often the device was used
        Control0..1
        TypeChoice of: Timing, Period, dateTime
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        20. DeviceUsage.dateAsserted
        Definition

        The time at which the statement was recorded by informationSource.

        ShortWhen the statement was made (and recorded)
        Control0..1
        TypedateTime
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        22. DeviceUsage.usageStatus
        Definition

        The status of the device usage, for example always, sometimes, never. This is not the same as the status of the statement.

        ShortThe status of the device usage, for example always, sometimes, never. This is not the same as the status of the statement
        Control0..1
        BindingThe codes SHALL be taken from DeviceUsageStatus
        (required to http://hl7.org/fhir/ValueSet/deviceusage-status)

        Codes representing the usage status of the device.

        TypeCodeableConcept
        24. DeviceUsage.usageReason
        Definition

        The reason for asserting the usage status - for example forgot, lost, stolen, broken.

        ShortThe reason for asserting the usage status - for example forgot, lost, stolen, broken
        Control0..*
        TypeCodeableConcept
        26. DeviceUsage.adherence
        Definition

        This indicates how or if the device is being used.

        ShortHow device is being used
        Control0..1
        TypeBackboneElement
        28. DeviceUsage.adherence.code
        Definition

        Type of adherence.

        Shortalways | never | sometimes
        Control1..1
        BindingFor example codes, see DeviceUsageAdherenceCode
        (example to http://hl7.org/fhir/ValueSet/deviceusage-adherence-code)

        Codes for adherence

        TypeCodeableConcept
        30. DeviceUsage.adherence.reason
        Definition

        Reason for adherence type.

        Shortlost | stolen | prescribed | broken | burned | forgot
        Control1..*
        BindingFor example codes, see DeviceUsageAdherenceReason
        (example to http://hl7.org/fhir/ValueSet/deviceusage-adherence-reason)

        Codes for adherence reason

        TypeCodeableConcept
        32. DeviceUsage.informationSource
        Definition

        Who reported the device was being used by the patient.

        ShortWho made the statement
        Comments

        Group is only allowed in the circumstance where the group represents a family or a household, and should not represent groups of Practitioners where other more specific resources can be used instead.

        Control0..1
        TypeReference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization, Group)
        34. DeviceUsage.device
        Definition

        Code or Reference to device used.

        ShortCode or Reference to device used
        Control1..1
        TypeCodeableReference(Device, DeviceDefinition)
        36. DeviceUsage.reason
        Definition

        Reason or justification for the use of the device. A coded concept, or another resource whose existence justifies this DeviceUsage.

        ShortWhy device was used
        Comments

        When the status is not done, the reason code indicates why it was not done.

        Control0..*
        TypeCodeableReference(Condition, Observation, DiagnosticReport, DocumentReference, Procedure)
        38. DeviceUsage.bodyStructure
        Definition

        Indicates the anatomic location on the subject's body where the device was used (i.e. the target).

        ShortTarget body structure
        Control0..1
        BindingFor example codes, see SNOMEDCTBodyStructures
        (example to http://hl7.org/fhir/ValueSet/body-site)

        SNOMED CT Body Structures

        TypeCodeableReference(BodyStructure)
        Requirements

        Knowing where the device is targeted is important for tracking if multiple sites are possible. If more information than just a code is required, use the extension BodyStructure Reference.

        40. DeviceUsage.note
        Definition

        Details about the device statement that were not represented at all or sufficiently in one of the attributes provided in a class. These may include for example a comment, an instruction, or a note associated with the statement.

        ShortAddition details (comments, instructions)
        Control0..*
        TypeAnnotation

        Guidance on how to interpret the contents of this table can be foundhere

        0. DeviceUsage
        Definition

        A record of a device being used by a patient where the record is the result of a report from the patient or a clinician.

        ShortRecord of use of a device
        Control0..*
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsdom-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.trace('id') in %resource.descendants().select(reference | as(uri))) or descendants().where(reference='#' | as(uri)='#').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())
        2. DeviceUsage.id
        Definition

        The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

        ShortLogical id of this artifact
        Comments

        Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

        Control0..1
        Typeid
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        4. DeviceUsage.meta
        Definition

        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.

        ShortMetadata about the resource
        Control0..1
        TypeMeta
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        6. DeviceUsage.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 its 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 its meaning or interpretation
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        8. DeviceUsage.language
        Definition

        The base language in which the resource is written.

        ShortLanguage of the resource content
        Comments

        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).

        Control0..1
        BindingThe codes SHALL be taken from AllLanguages
        (required to http://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot3)

        IETF language tag for a human language

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        10. DeviceUsage.text
        Definition

        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.

        ShortText summary of the resource, for human interpretation
        Comments

        Contained resources do not have a 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.

        Control0..1
        This element is affected by the following invariants: dom-6
        TypeNarrative
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Alternate Namesnarrative, html, xhtml, display
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        12. DeviceUsage.contained
        Definition

        These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

        ShortContained, inline Resources
        Comments

        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. Contained resources may be a resource type defined in the FHIR specification, or an additional resource.

        Control0..*
        This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
        TypeResource
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Alternate Namesinline resources, anonymous resources, contained resources
        14. DeviceUsage.extension
        Definition

        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 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.

        ShortAdditional 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..*
        TypeExtension
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on DeviceUsage.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 16. DeviceUsage.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 managable, 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
          Must Supportfalse
          Summarytrue
          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()))
          SlicingThis element introduces a set of slices on DeviceUsage.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 18. DeviceUsage.identifier
            Definition

            An external identifier for this statement such as an IRI.

            ShortExternal identifier for this record
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..*
            TypeIdentifier
            Summarytrue
            20. DeviceUsage.basedOn
            Definition

            A plan, proposal or order that is fulfilled in whole or in part by this DeviceUsage.

            ShortFulfills plan, proposal or order
            Control0..*
            TypeReference(ServiceRequest)
            Summarytrue
            Requirements

            Allows tracing of authorization for the DeviceUsage and tracking whether proposals/recommendations were acted upon.

            Alternate Namesfulfills
            22. DeviceUsage.partOf
            Definition

            A larger event of which this particular device usage is one part the usage.

            ShortPart of referenced device usage
            Control0..*
            TypeReference(DeviceUsage)
            Summarytrue
            24. DeviceUsage.status
            Definition

            The current state of the device usage.

            Shortpreparation | active | completed | not-done | entered-in-error +
            Comments

            DeviceUsage is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for contains codes that assert the status of the use by the patient (for example, stopped or on hold) as well as codes that assert the status of the resource itself (for example, entered in error).

            This element is labeled as a modifier because the status contains the codes that mark the statement as not currently valid. When the status is 'not-done', the event-statusReason extension should be used to indicate why the DeviceUsage was not done.

            Control1..1
            BindingThe codes SHALL be taken from DeviceUsageStatus
            (required to http://hl7.org/fhir/ValueSet/deviceusage-status)

            A coded concept indicating the current status of the Device Usage.

            Typecode
            Is Modifiertrue because 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
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            26. DeviceUsage.category
            Definition

            This attribute indicates a category for the statement - The device statement may be made in an inpatient or outpatient settting (inpatient | outpatient | community | patientspecified).

            ShortThe category of the statement - classifying how the statement is made
            Control0..*
            TypeCodeableConcept
            28. DeviceUsage.subject
            Definition

            The individual(s) who used the device.

            ShortIndividuals(s) who used the device
            Comments

            Group is only allowed in the circumstance where the group represents a family or a household, and should not represent groups of Practitioners where other more specific resources can be used instead.

            Control1..1
            TypeReference(Patient, Group)
            Summarytrue
            30. DeviceUsage.derivedFrom
            Definition

            Allows linking the DeviceUsage to the underlying Request, or to other information that supports or is used to derive the DeviceUsage.

            ShortSupporting information
            Comments

            The most common use cases for deriving a DeviceUsage comes from creating it from a request or from an observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the DeviceUsage from.

            Control0..*
            TypeReference(ServiceRequest, Procedure, Claim, Observation, QuestionnaireResponse, DocumentReference)
            Summarytrue
            32. DeviceUsage.context
            Definition

            The encounter or episode of care that establishes the context for this device use statement.

            ShortThe encounter or episode of care that establishes the context for this device use statement
            Control0..1
            TypeReference(Encounter, EpisodeOfCare)
            Summarytrue
            34. DeviceUsage.timing[x]
            Definition

            How often the device was used.

            ShortHow often the device was used
            Control0..1
            TypeChoice of: Timing, Period, dateTime
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            36. DeviceUsage.dateAsserted
            Definition

            The time at which the statement was recorded by informationSource.

            ShortWhen the statement was made (and recorded)
            Control0..1
            TypedateTime
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            38. DeviceUsage.usageStatus
            Definition

            The status of the device usage, for example always, sometimes, never. This is not the same as the status of the statement.

            ShortThe status of the device usage, for example always, sometimes, never. This is not the same as the status of the statement
            Control0..1
            BindingThe codes SHALL be taken from DeviceUsageStatus
            (required to http://hl7.org/fhir/ValueSet/deviceusage-status)

            Codes representing the usage status of the device.

            TypeCodeableConcept
            40. DeviceUsage.usageReason
            Definition

            The reason for asserting the usage status - for example forgot, lost, stolen, broken.

            ShortThe reason for asserting the usage status - for example forgot, lost, stolen, broken
            Control0..*
            TypeCodeableConcept
            42. DeviceUsage.adherence
            Definition

            This indicates how or if the device is being used.

            ShortHow device is being used
            Control0..1
            TypeBackboneElement
            Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
            44. DeviceUsage.adherence.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
            46. DeviceUsage.adherence.extension
            Definition

            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.

            ShortAdditional 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..*
            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()))
            SlicingThis element introduces a set of slices on DeviceUsage.adherence.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 48. DeviceUsage.adherence.modifierExtension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 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. 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 even if unrecognized
              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 element that contains them
              Summarytrue
              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, modifiers
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              50. DeviceUsage.adherence.code
              Definition

              Type of adherence.

              Shortalways | never | sometimes
              Control1..1
              BindingFor example codes, see DeviceUsageAdherenceCode
              (example to http://hl7.org/fhir/ValueSet/deviceusage-adherence-code)

              Codes for adherence

              TypeCodeableConcept
              52. DeviceUsage.adherence.reason
              Definition

              Reason for adherence type.

              Shortlost | stolen | prescribed | broken | burned | forgot
              Control1..*
              BindingFor example codes, see DeviceUsageAdherenceReason
              (example to http://hl7.org/fhir/ValueSet/deviceusage-adherence-reason)

              Codes for adherence reason

              TypeCodeableConcept
              54. DeviceUsage.informationSource
              Definition

              Who reported the device was being used by the patient.

              ShortWho made the statement
              Comments

              Group is only allowed in the circumstance where the group represents a family or a household, and should not represent groups of Practitioners where other more specific resources can be used instead.

              Control0..1
              TypeReference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization, Group)
              Summarytrue
              56. DeviceUsage.device
              Definition

              Code or Reference to device used.

              ShortCode or Reference to device used
              Control1..1
              TypeCodeableReference(Device, DeviceDefinition)
              Summarytrue
              58. DeviceUsage.reason
              Definition

              Reason or justification for the use of the device. A coded concept, or another resource whose existence justifies this DeviceUsage.

              ShortWhy device was used
              Comments

              When the status is not done, the reason code indicates why it was not done.

              Control0..*
              TypeCodeableReference(Condition, Observation, DiagnosticReport, DocumentReference, Procedure)
              Summarytrue
              60. DeviceUsage.bodyStructure
              Definition

              Indicates the anatomic location on the subject's body where the device was used (i.e. the target).

              ShortTarget body structure
              Control0..1
              BindingFor example codes, see SNOMEDCTBodyStructures
              (example to http://hl7.org/fhir/ValueSet/body-site)

              SNOMED CT Body Structures

              TypeCodeableReference(BodyStructure)
              Summarytrue
              Requirements

              Knowing where the device is targeted is important for tracking if multiple sites are possible. If more information than just a code is required, use the extension BodyStructure Reference.

              62. DeviceUsage.note
              Definition

              Details about the device statement that were not represented at all or sufficiently in one of the attributes provided in a class. These may include for example a comment, an instruction, or a note associated with the statement.

              ShortAddition details (comments, instructions)
              Control0..*
              TypeAnnotation