Personal Health Device Implementation Guide
3.0.0-draft - STU 3 - R6 Global (Whole world)

Personal Health Device Implementation Guide, published by HL7 International / Devices. This guide is not an authorized publication; it is the continuous build for version 3.0.0-draft built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/phd/ and changes regularly. See the Directory of published versions

Resource Profile: PhdDeviceAlert - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 1

Definitions for the PhdDeviceAlert resource profile

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

0. DeviceAlert
Definition

Describes a noteworthy condition or occurrence determined to exist by a device.

ShortDocumentation of an alert (a.k.a. alarm) generated by a device indicating a noteworthy condition
Comments

The DeviceAlert resource is derived from the ISO/IEEE 11073-10201 Domain Information Model standard, but is more widely applicable.

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. DeviceAlert.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. For DomainResources, if more than one implicitRules policy applies, additional policies may be conveyed using the additionalImplicitRules extension.

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()))
4. DeviceAlert.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
6. DeviceAlert.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 DeviceAlert.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 8. DeviceAlert.status
    Definition

    The current state of the device alert.

    Shortin-progress | completed | entered-in-error | unknown
    Comments

    Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is.

    Control1..1
    BindingThe codes SHALL be taken from DeviceAlertStatusCodeshttp://hl7.org/fhir/ValueSet/devicealert-status|6.0.0-ballot5
    (required to http://hl7.org/fhir/ValueSet/devicealert-status|6.0.0-ballot5)

    in-progress | completed | entered-in-error | unknown

    Typecode
    Is Modifiertrue because This element is labeled as a modifier because it has a potential code that indicates the Alert was entered in error.
    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()))
    10. DeviceAlert.code
    Definition

    MDC nomenclature code from partition 3 indicating the alert condition being reported


    A code that indicates the specific condition that triggered the alert.

    ShortCode for the alert conditionThe meaning of the alert
    Comments

    The code identifies the specific alert condition from the IEEE 11073 medical device communication nomenclature.

    Control1..1
    BindingThe codes SHALL be taken from The codes SHOULD be taken from DeviceAlertConditionCodes (2.0.0)http://terminology.hl7.org/ValueSet/devicealert-condition
    (required to http://terminology.hl7.org/ValueSet/devicealert-condition|2.0.0)
    TypeCodeableConcept
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. DeviceAlert.subject
    Definition

    Who or what the alert is about.

    ShortWho or what the alert is about
    Control1..1
    TypeReference(Patient, Device, BiologicallyDerivedProduct, Group, Location, Medication, NutritionProduct, Specimen)
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Requirements

    Links the device alert to the appropriate subject context. May also affect access control.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. DeviceAlert.occurrence
    Definition

    This element is used to record the time period when the alert condition did occur or is occurring.

    ShortWhen the alert condition occurred/is occurring
    Comments

    This element is used to record the time period during which the alert condition is or was active. The absence of occurrence.end usually indicates that the alert condition was ongoing at the last update. Coincident occurrence.start and occurrence.end values allow the expression of instantaneous alert conditions. Implementers should remain aware that partially specified dateTime values for occurrence.start or occurrence.end are ambiguous about what point in time they represent. Corner cases, such representing an alert condition known to be ongoing without knowledge of the start time, may require special handling such as use of extensions—consult relevant implementation guides.

    Control1..1
    TypePeriod
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. DeviceAlert.derivedFrom
    Definition

    References to the PhdNumericObservation, PhdCompoundNumericObservation, PhdCompoundObservation, or other observations that this alert condition is derived from or associated with.


    The value causing the alert condition.

    ShortReference to the observation(s) this alert is associated withThe value causing the alert condition
    Comments

    The alert is now represented as a separate resource that references the source measurement observation(s) via derivedFrom. The component element can be used to identify a specific component in case of an alert on a compound observation, e.g. on systolic blood pressure in a blood pressure observation.

    Control10..*
    TypeBackboneElement
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
    18. DeviceAlert.derivedFrom.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()))
    SlicingThis element introduces a set of slices on DeviceAlert.derivedFrom.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 20. DeviceAlert.derivedFrom.observation
      Definition

      Indicates the Observation whose value is causing the alert condition; or, if component is present, the Observation with a component causing the alert condition.

      ShortThe Observation having a value causing the alert condition
      Control1..1
      TypeReference(PhdNumericObservation, PhdCompoundNumericObservation, PhdCompoundObservation, Observation)
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. DeviceAlert.label
      Definition

      Notification message displayed when the threshold is crossed.


      The label might combine information from the alert code, priority, the measurement type, measurement value, body sites and other sources, e.g., “HR > 180”.

      ShortThreshold notification textText to be displayed for the alert condition
      Control0..1
      Typestring
      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()))
      24. DeviceAlert.signal
      Definition

      Annunciation or notification of the alert condition.

      ShortAnnunciation or notification of the alert condition
      Control0..*
      TypeBackboneElement
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on DeviceAlert.signal. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ type
      • Guidance on how to interpret the contents of this table can be foundhere

        0. DeviceAlert
        2. DeviceAlert.code
        Definition

        MDC nomenclature code from partition 3 indicating the alert condition being reported

        ShortCode for the alert condition
        Comments

        The code identifies the specific alert condition from the IEEE 11073 medical device communication nomenclature.

        BindingThe codes SHALL be taken from DeviceAlertConditionCodes (2.0.0)
        (required to http://terminology.hl7.org/ValueSet/devicealert-condition|2.0.0)
        4. DeviceAlert.derivedFrom
        Definition

        References to the PhdNumericObservation, PhdCompoundNumericObservation, PhdCompoundObservation, or other observations that this alert condition is derived from or associated with.

        ShortReference to the observation(s) this alert is associated with
        Comments

        The alert is now represented as a separate resource that references the source measurement observation(s) via derivedFrom. The component element can be used to identify a specific component in case of an alert on a compound observation, e.g. on systolic blood pressure in a blood pressure observation.

        Control1..?
        6. DeviceAlert.derivedFrom.observation
        TypeReference(PhdNumericObservation, PhdCompoundNumericObservation, PhdCompoundObservation)
        8. DeviceAlert.label
        Definition

        Notification message displayed when the threshold is crossed.

        ShortThreshold notification text
        10. DeviceAlert.signal
        SlicingThis element introduces a set of slices on DeviceAlert.signal. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ type
        • Guidance on how to interpret the contents of this table can be foundhere

          0. DeviceAlert
          Definition

          Describes a noteworthy condition or occurrence determined to exist by a device.

          ShortDocumentation of an alert (a.k.a. alarm) generated by a device indicating a noteworthy condition
          Comments

          The DeviceAlert resource is derived from the ISO/IEEE 11073-10201 Domain Information Model standard, but is more widely applicable.

          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. DeviceAlert.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 resource id depends on the given use case.

          Control0..1
          Typeid
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          4. DeviceAlert.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. DeviceAlert.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. For DomainResources, if more than one implicitRules policy applies, additional policies may be conveyed using the additionalImplicitRules extension.

          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. DeviceAlert.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-ballot5)

          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. DeviceAlert.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. DeviceAlert.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. DeviceAlert.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 DeviceAlert.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 16. DeviceAlert.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 DeviceAlert.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 18. DeviceAlert.identifier
              Definition

              Business identifiers assigned to this alert, by the source device, gateway software, manufacturers, or other systems or organizations. These identifiers remain constant as the resource is updated and propagates from server to server.

              ShortBusiness identifier for this device alert
              Comments

              Note: This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For identifiers assigned to an alert by the device or gateway software, the system element of the identifier might be set to an identifier of the device.

              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..*
              TypeIdentifier
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Requirements

              Allows identification of the device alert as it is known by various participating systems and in a way that remains consistent across servers.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              20. DeviceAlert.procedure
              Definition

              The procedure (or procedures) during which the alert condition was raised.

              ShortProcedure during which the alert occurred
              Control0..*
              TypeReference(Procedure)
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              22. DeviceAlert.status
              Definition

              The current state of the device alert.

              Shortin-progress | completed | entered-in-error | unknown
              Comments

              Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is.

              Control1..1
              BindingThe codes SHALL be taken from DeviceAlertStatusCodes
              (required to http://hl7.org/fhir/ValueSet/devicealert-status|6.0.0-ballot5)

              in-progress | completed | entered-in-error | unknown

              Typecode
              Is Modifiertrue because This element is labeled as a modifier because it has a potential code that indicates the Alert was entered in error.
              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()))
              24. DeviceAlert.category
              Definition

              Partitions the device alert into one or more categories that can be used to filter searching, to govern access control and/or to guide system behavior.

              ShortHigh level categorization of device alert
              Comments

              Categorization might be done automatically (inferred by code) or manually by user assertion. The absence of a category may limit the ability to determine when the element should be handled, so strong consideration should be given to how systems will be able to determine category values for legacy data and how data that cannot be categorized will be handled. As well, some categories might not be mutually exclusive, so systems should prepare for multiple declared categories - even within a single category 'axis'.

              Control0..*
              BindingFor example codes, see DeviceAlert Category Codes
              (example to http://terminology.hl7.org/ValueSet/devicealert-category)
              TypeCodeableConcept
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              26. DeviceAlert.type
              Definition

              The particular kind of alert, such as whether it is related to the patient condition; to irregular device state; or to workflow or regular device state, such as timers.

              ShortThe particular kind of alert
              Control0..1
              BindingUnless not suitable, these codes SHALL be taken from DeviceAlert Type Codes
              (extensible to http://terminology.hl7.org/ValueSet/devicealert-type)
              TypeCodeableConcept
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              28. DeviceAlert.priority
              Definition

              The urgency by which the condition ought to be addressed. The alert priority is usually reported by the source device. The element MAY be omitted if the priority is unknown.

              ShortThe urgency by which the condition ought to be addressed
              Control0..1
              BindingUnless not suitable, these codes SHALL be taken from DeviceAlertPriorityCodes
              (extensible to http://hl7.org/fhir/ValueSet/devicealert-priority|6.0.0-ballot5)
              TypeCodeableConcept
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              30. DeviceAlert.code
              Definition

              MDC nomenclature code from partition 3 indicating the alert condition being reported

              ShortCode for the alert condition
              Comments

              The code identifies the specific alert condition from the IEEE 11073 medical device communication nomenclature.

              Control1..1
              BindingThe codes SHALL be taken from DeviceAlertConditionCodes (2.0.0)
              (required to http://terminology.hl7.org/ValueSet/devicealert-condition|2.0.0)
              TypeCodeableConcept
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              32. DeviceAlert.subject
              Definition

              Who or what the alert is about.

              ShortWho or what the alert is about
              Control1..1
              TypeReference(Patient, Device, BiologicallyDerivedProduct, Group, Location, Medication, NutritionProduct, Specimen)
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Requirements

              Links the device alert to the appropriate subject context. May also affect access control.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              34. DeviceAlert.encounter
              Definition

              The Encounter during which the alert condition was raised.

              ShortEncounter during which the alert condition occurred
              Control0..1
              TypeReference(Encounter)
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Requirements

              Links the device alert to the Encounter context. May also affect access control.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              36. DeviceAlert.occurrence
              Definition

              This element is used to record the time period when the alert condition did occur or is occurring.

              ShortWhen the alert condition occurred/is occurring
              Comments

              This element is used to record the time period during which the alert condition is or was active. The absence of occurrence.end usually indicates that the alert condition was ongoing at the last update. Coincident occurrence.start and occurrence.end values allow the expression of instantaneous alert conditions. Implementers should remain aware that partially specified dateTime values for occurrence.start or occurrence.end are ambiguous about what point in time they represent. Corner cases, such representing an alert condition known to be ongoing without knowledge of the start time, may require special handling such as use of extensions—consult relevant implementation guides.

              Control1..1
              TypePeriod
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              38. DeviceAlert.device
              Definition

              Indicates the device that detected the alert condition. The device could be a top-level Device or component Device (such as an MDS, VMD, or Channel); or might identify the specific DeviceMetric of a Device (e.g., a heart rate reading) that was in an alert condition.

              ShortThe Device (or DeviceMetric) that detected the alert condition
              Control0..1
              TypeReference(Device, DeviceMetric)
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              40. DeviceAlert.acknowledged
              Definition

              An indication of whether (true) or not (false) the alert condition has been acknowledged.

              ShortWhether the alert condition has been acknowledged
              Control0..1
              Typeboolean
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supportfalse
              Summaryfalse
              Meaning if MissingIf absent, no inference SHOULD be made about whether the alert condition has been acknowledged.
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              42. DeviceAlert.acknowledgedBy
              Definition

              An indication of who or what acknowledged the alert condition.

              ShortWho acknowledged the alert condition
              Control0..1
              TypeReference(Patient, Device, Practitioner, PractitionerRole, RelatedPerson)
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              44. DeviceAlert.location
              Definition

              The principal physical location of the subject at the time the alert condition occurred. This could be different from the location of the alerting device at that time, and from the current location of either the subject or the alert condition detecting device.

              ShortLocation of the subject when the alert was raised
              Control0..1
              TypeReference(Location)
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Requirements

              Provides context around the alert occurrence (e.g. if it occurred inside or outside a dedicated healthcare setting).

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              46. DeviceAlert.derivedFrom
              Definition

              References to the PhdNumericObservation, PhdCompoundNumericObservation, PhdCompoundObservation, or other observations that this alert condition is derived from or associated with.

              ShortReference to the observation(s) this alert is associated with
              Comments

              The alert is now represented as a separate resource that references the source measurement observation(s) via derivedFrom. The component element can be used to identify a specific component in case of an alert on a compound observation, e.g. on systolic blood pressure in a blood pressure observation.

              Control1..*
              TypeBackboneElement
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
              48. DeviceAlert.derivedFrom.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
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              50. DeviceAlert.derivedFrom.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 DeviceAlert.derivedFrom.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 52. DeviceAlert.derivedFrom.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()))
                SlicingThis element introduces a set of slices on DeviceAlert.derivedFrom.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 54. DeviceAlert.derivedFrom.observation
                  Definition

                  Indicates the Observation whose value is causing the alert condition; or, if component is present, the Observation with a component causing the alert condition.

                  ShortThe Observation having a value causing the alert condition
                  Control1..1
                  TypeReference(PhdNumericObservation, PhdCompoundNumericObservation, PhdCompoundObservation)
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  56. DeviceAlert.derivedFrom.component
                  Definition

                  If applicable, the code of the component (of the Observation identified in derivedFrom.observation) having a value causing the alert condition. This might be used when the alert is associated with a specific component of an Observation, rather than the overall Observation; for example, a low diastolic blood pressure. Since the component is identified by matching Observation.component.code, if more than one component have the same code, the specific component is ambiguous. Repetitions of this element indicate additional components contributing to the alert condition.

                  ShortThe Observation.component having a value causing the alert condition
                  Control0..1
                  BindingFor example codes, see LOINCCodes
                  (example to http://hl7.org/fhir/ValueSet/observation-codes|6.0.0-ballot5)

                  Codes identifying names of simple observations.

                  TypeCoding
                  Is Modifierfalse
                  Must Supportfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  58. DeviceAlert.derivedFrom.limit
                  Definition

                  The limits beyond which a value was detected to cause the alert condition. The actual value is the Observation.value[x] referenced by derivedFrom.observation or, if specified, the Observation.component.value[x] of the component (with Observation.component.code matching derivedFrom.component) of the reference Observation.

                  ShortThe boundaries beyond which a value was detected to cause the alert condition
                  Control0..1
                  TypeRange
                  Is Modifierfalse
                  Must Supportfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  60. DeviceAlert.label
                  Definition

                  Notification message displayed when the threshold is crossed.

                  ShortThreshold notification text
                  Control0..1
                  Typestring
                  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()))
                  62. DeviceAlert.signal
                  Definition

                  Annunciation or notification of the alert condition.

                  ShortAnnunciation or notification of the alert condition
                  Control0..*
                  TypeBackboneElement
                  Is Modifierfalse
                  Must Supportfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
                  SlicingThis element introduces a set of slices on DeviceAlert.signal. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ type