RIVO-Noord Zorgviewer Implementation Guide
1.28.0 - master Netherlands flag

RIVO-Noord Zorgviewer Implementation Guide, published by RIVO-NN HL7NL. This guide is not an authorized publication; it is the continuous build for version 1.28.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/RIVO-Noord/zorgviewer-ig/ and changes regularly. See the Directory of published versions

Resource Profile: MedischHulpmiddel - Detailed Descriptions

Active as of 2026-11-12

Definitions for the MedischHulpmiddel resource profile.

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

0. DeviceUseStatement
Definition

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


This is the base resource type for everything.

ShortMedicalDeviceBase Resource
Control0..*
Alternate NamesMedischHulpmiddel
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
2. DeviceUseStatement.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.

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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Control0..1
Typeuri
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
4. DeviceUseStatement.extension:HealthcareProvider
Slice NameHealthcareProvider
Definition

The healthcare provider at which use of the medical aid was initiated or where the aid was implanted.

ShortHealthcareProvider
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..1
This element is affected by the following invariants: ele-1
TypeExtension(HCIM MedicalDevice Organization) (Extension Type: Reference(nl-core-organization))
Alternate Namesextensions, user content, Zorgaanbieder
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. DeviceUseStatement.extension:HealthProfessional
Slice NameHealthProfessional
Definition

The healthcare provider involved in the indication for use of the medical aid implant.

ShortHealthProfessional
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..1
This element is affected by the following invariants: ele-1
TypeExtension(HCIM MedicalDevice Practitioner) (Extension Type: Reference(nl-core-practitioner, nl-core-practitionerrole))
Alternate Namesextensions, user content, Zorgverlener
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. DeviceUseStatement.extension:HealthProfessional.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, 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.

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..0*
TypeExtension
Alternate Namesextensions, user content
SlicingThis element introduces a set of slices on DeviceUseStatement.extension.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
10. DeviceUseStatement.extension:HealthProfessional.url
Definition

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

Shortidentifies the meaning of the extension
Comments

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

Control1..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed Value
{
  "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDevice-Practitioner"
}
<url value="http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDevice-Practitioner"/>
12. DeviceUseStatement.extension:HealthProfessional.valueReference:valueReference
Slice NamevalueReference
Definition

The healthcare provider involved in the indication for use of the medical device implant.


Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

ShortHealthProfessionalValue of extension
Control0..1
TypeReference(nl-core-practitioner, nl-core-practitionerrole), date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept
Alternate NamesZorgverlener
14. DeviceUseStatement.extension:reasonReference
Slice NamereasonReference
Definition

Another resource whose existence justifies this DeviceUseStatement.

ShortWhy was DeviceUseStatement performed?
Comments

This extension is backported from the offical HL7 DeviceUseStatement specification in FHIR R4.

Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(Backported DeviceUseStatement.reasonReference for STU3) (Extension Type: Reference(Condition, Observation, DiagnosticReport, DocumentReference, Media))
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
16. DeviceUseStatement.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. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, 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.

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 No Modifier Reason provideed in previous versions of FHIR
Alternate Namesextensions, user content
18. DeviceUseStatement.status
Definition

A code representing the patient or other source's judgment about the state of the device used that this statement is about. Generally this will be active or completed.

Shortactive | completed | entered-in-error +
Comments

DeviceUseStatment 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.

Control1..1
BindingThe codes SHALL be taken from DeviceUseStatementStatushttp://hl7.org/fhir/ValueSet/device-statement-status|3.0.2
(required to http://hl7.org/fhir/ValueSet/device-statement-status)

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

Typecode
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
20. DeviceUseStatement.subject
Definition

The patient who used the device.

ShortPatient using device
Control1..1
TypeReference(Group, nl-core-patient, Patient)
22. DeviceUseStatement.whenUsed
Definition

The time period over which the device was used.

ShortTime range defined by start and end date/timePeriod device was used
Control0..1
TypePeriod
Must Supporttrue
Alternate NamesTijdsduur gedefinieerd door start- en einddatum/tijd
24. DeviceUseStatement.device
Definition

The details of the device used.

ShortReference to device used
Control1..1
TypeReference(HCIM MedicalDevice Product, Device)
Must Supporttrue
26. DeviceUseStatement.indication
Definition

Reason or justification for the use of the device.

ShortWhy device was used
Control0..*
TypeCodeableConcept
Must Supporttrue
28. DeviceUseStatement.indication.extension:indication_Problem
Slice Nameindication_Problem
Definition

The medical reason for use of the medical device.

ShortIndication-Probleem
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..*
This element is affected by the following invariants: ele-1
TypeExtension(HCIM MedicalDevice Problem) (Extension Type: Reference(HCIM Problem))
Alternate Namesextensions, user content, Indicatie
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
30. DeviceUseStatement.bodySite
Definition

Patient’s anatomical location of the medical device used.


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

ShortAnatomicalLocationTarget body site
Control0..1
BindingUnless not suitable, these codes SHALL be taken from For example codes, see HulpmiddelAnatomischeLocatieCodelijsthttp://hl7.org/fhir/ValueSet/body-site|3.0.2
(extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.10.1.2--20171231000000)

Patient’s anatomical location of the medical aid used.


Codes describing anatomical locations. May include laterality.

TypeCodeableConcept
Must Supporttrue
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 http://hl7.org/fhir/StructureDefinition/body-site-instance.


​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 http://hl7.org/fhir/StructureDefinition/body-site-instance.

Alternate NamesAnatomischeLocatie
32. DeviceUseStatement.bodySite.extension:Laterality
Slice NameLaterality
Definition

Laterality adds information about body side to the anatomic location, e.g. left

ShortLaterality
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..1
This element is affected by the following invariants: ele-1
TypeExtension(BodySite Qualifier) (Extension Type: CodeableConcept)
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
34. DeviceUseStatement.bodySite.extension:Laterality.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, 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.

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..0*
TypeExtension
Alternate Namesextensions, user content
SlicingThis element introduces a set of slices on DeviceUseStatement.bodySite.extension.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
36. DeviceUseStatement.bodySite.extension:Laterality.url
Definition

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

Shortidentifies the meaning of the extension
Comments

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

Control1..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed Value
{
  "url" : "http://nictiz.nl/fhir/StructureDefinition/BodySite-Qualifier"
}
<url value="http://nictiz.nl/fhir/StructureDefinition/BodySite-Qualifier"/>
38. DeviceUseStatement.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
Must Supporttrue
40. DeviceUseStatement.note.text
Definition

Comment about use or information on the medical aid used.


The text of the annotation.

ShortCommentThe annotation - text content
Control1..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Alternate NamesToelichting

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

0. DeviceUseStatement
2. DeviceUseStatement.whenUsed
Must Supporttrue
4. DeviceUseStatement.device
Must Supporttrue
6. DeviceUseStatement.indication
Must Supporttrue
8. DeviceUseStatement.bodySite
Must Supporttrue
10. DeviceUseStatement.note
Must Supporttrue

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

0. DeviceUseStatement
Definition

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

ShortMedicalDevice
Control0..*
Alternate NamesMedischHulpmiddel
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
2. DeviceUseStatement.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

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control0..1
Typeid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
4. DeviceUseStatement.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

ShortMetadata about the resource
Control0..1
TypeMeta
Summarytrue
6. DeviceUseStatement.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.

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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Control0..1
Typeuri
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
8. DeviceUseStatement.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
BindingUnless not suitable, these codes SHALL be taken from Common Languages
(extensible to http://hl7.org/fhir/ValueSet/languages)

A human language.

Additional BindingsPurpose
All LanguagesMax Binding
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
10. DeviceUseStatement.text
Definition

A human-readable narrative that contains a summary of the resource, and may 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 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 in formation is added later.

Control0..1
This element is affected by the following invariants: dom-1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
12. DeviceUseStatement.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

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.

Control0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained resources
14. DeviceUseStatement.extension
Definition

May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, 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.

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
Alternate Namesextensions, user content
SlicingThis element introduces a set of slices on DeviceUseStatement.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
16. DeviceUseStatement.extension:HealthcareProvider
Slice NameHealthcareProvider
Definition

The healthcare provider at which use of the medical aid was initiated or where the aid was implanted.

ShortHealthcareProvider
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..1
This element is affected by the following invariants: ele-1
TypeExtension(HCIM MedicalDevice Organization) (Extension Type: Reference(nl-core-organization))
Alternate Namesextensions, user content, Zorgaanbieder
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. DeviceUseStatement.extension:HealthProfessional
Slice NameHealthProfessional
Definition

The healthcare provider involved in the indication for use of the medical aid implant.

ShortHealthProfessional
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..1
This element is affected by the following invariants: ele-1
TypeExtension(HCIM MedicalDevice Practitioner) (Extension Type: Reference(nl-core-practitioner, nl-core-practitionerrole))
Alternate Namesextensions, user content, Zorgverlener
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
20. DeviceUseStatement.extension:HealthProfessional.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Shortxml:id (or equivalent in JSON)
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
22. DeviceUseStatement.extension:HealthProfessional.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, 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.

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..0
TypeExtension
Alternate Namesextensions, user content
SlicingThis element introduces a set of slices on DeviceUseStatement.extension.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
24. DeviceUseStatement.extension:HealthProfessional.url
Definition

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

Shortidentifies the meaning of the extension
Comments

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

Control1..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed Value
{
  "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDevice-Practitioner"
}
<url value="http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDevice-Practitioner"/>
26. DeviceUseStatement.extension:HealthProfessional.valueReference:valueReference
Slice NamevalueReference
Definition

The healthcare provider involved in the indication for use of the medical device implant.

ShortHealthProfessional
Control0..1
TypeReference(nl-core-practitioner, nl-core-practitionerrole)
Alternate NamesZorgverlener
28. DeviceUseStatement.extension:reasonReference
Slice NamereasonReference
Definition

Another resource whose existence justifies this DeviceUseStatement.

ShortWhy was DeviceUseStatement performed?
Comments

This extension is backported from the offical HL7 DeviceUseStatement specification in FHIR R4.

Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(Backported DeviceUseStatement.reasonReference for STU3) (Extension Type: Reference(Condition, Observation, DiagnosticReport, DocumentReference, Media))
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
30. DeviceUseStatement.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. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, 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.

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 No Modifier Reason provideed in previous versions of FHIR
Alternate Namesextensions, user content
32. DeviceUseStatement.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
34. DeviceUseStatement.status
Definition

A code representing the patient or other source's judgment about the state of the device used that this statement is about. Generally this will be active or completed.

Shortactive | completed | entered-in-error +
Comments

DeviceUseStatment 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.

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

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

Typecode
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
36. DeviceUseStatement.subject
Definition

The patient who used the device.

ShortPatient using device
Control1..1
TypeReference(Group, nl-core-patient)
38. DeviceUseStatement.whenUsed
Definition

The time period over which the device was used.

ShortTime range defined by start and end date/time
Control0..1
TypePeriod
Must Supporttrue
Alternate NamesTijdsduur gedefinieerd door start- en einddatum/tijd
40. DeviceUseStatement.whenUsed.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Shortxml:id (or equivalent in JSON)
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
42. DeviceUseStatement.whenUsed.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, 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.

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
Alternate Namesextensions, user content
SlicingThis element introduces a set of slices on DeviceUseStatement.whenUsed.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
44. DeviceUseStatement.whenUsed.start
Definition

The start date of the first use or implant of the medical aid. A ‘vague’ date, such as only the year, is permitted.

ShortStartDate
Comments

If the low element is missing, the meaning is that the low boundary is not known.

Control0..1
This element is affected by the following invariants: per-1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate NamesBeginDatum
46. DeviceUseStatement.whenUsed.end
Definition

The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

ShortEnd time with inclusive boundary, if not ongoing
Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

Control0..1
This element is affected by the following invariants: per-1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
48. DeviceUseStatement.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
50. DeviceUseStatement.recordedOn
Definition

The time at which the statement was made/recorded.

ShortWhen statement was recorded
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
52. DeviceUseStatement.source
Definition

Who reported the device was being used by the patient.

ShortWho made the statement
Control0..1
TypeReference(nl-core-patient, nl-core-practitioner, nl-core-relatedperson)
54. DeviceUseStatement.source.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Shortxml:id (or equivalent in JSON)
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
56. DeviceUseStatement.source.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, 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.

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
Alternate Namesextensions, user content
SlicingThis element introduces a set of slices on DeviceUseStatement.source.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
58. DeviceUseStatement.source.extension:practitionerRole
Slice NamepractitionerRole
Definition

Optional Extension Element - found in all resources.

ShortOptional Extensions Element
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..1
This element is affected by the following invariants: ele-1
TypeExtension(PractitionerRole Reference) (Extension Type: Reference(nl-core-practitionerrole))
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
60. DeviceUseStatement.source.reference
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

ShortLiteral reference, Relative, internal or absolute URL
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Control0..1
This element is affected by the following invariants: ref-1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
62. DeviceUseStatement.source.identifier
Definition

An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

ShortLogical reference, when literal reference is not known
Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
TypeIdentifier
Summarytrue
64. DeviceUseStatement.source.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

ShortText alternative for the resource
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
66. DeviceUseStatement.device
Definition

The details of the device used.

ShortReference to device used
Control1..1
TypeReference(HCIM MedicalDevice Product)
Must Supporttrue
68. DeviceUseStatement.indication
Definition

Reason or justification for the use of the device.

ShortWhy device was used
Control0..*
TypeCodeableConcept
Must Supporttrue
70. DeviceUseStatement.indication.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Shortxml:id (or equivalent in JSON)
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
72. DeviceUseStatement.indication.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, 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.

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
Alternate Namesextensions, user content
SlicingThis element introduces a set of slices on DeviceUseStatement.indication.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
74. DeviceUseStatement.indication.extension:indication_Problem
Slice Nameindication_Problem
Definition

The medical reason for use of the medical device.

ShortIndication-Probleem
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..*
This element is affected by the following invariants: ele-1
TypeExtension(HCIM MedicalDevice Problem) (Extension Type: Reference(HCIM Problem))
Alternate Namesextensions, user content, Indicatie
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
76. DeviceUseStatement.indication.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Control0..*
TypeCoding
Summarytrue
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

78. DeviceUseStatement.indication.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

ShortPlain text representation of the concept
Comments

Very often the text is the same as a displayName of one of the codings.

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

80. DeviceUseStatement.bodySite
Definition

Patient’s anatomical location of the medical device used.

ShortAnatomicalLocation
Control0..1
BindingUnless not suitable, these codes SHALL be taken from HulpmiddelAnatomischeLocatieCodelijst
(extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.10.1.2--20171231000000)

Patient’s anatomical location of the medical aid used.

TypeCodeableConcept
Must Supporttrue
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 http://hl7.org/fhir/StructureDefinition/body-site-instance.

Alternate NamesAnatomischeLocatie
82. DeviceUseStatement.bodySite.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Shortxml:id (or equivalent in JSON)
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
84. DeviceUseStatement.bodySite.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, 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.

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
Alternate Namesextensions, user content
SlicingThis element introduces a set of slices on DeviceUseStatement.bodySite.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
86. DeviceUseStatement.bodySite.extension:Laterality
Slice NameLaterality
Definition

Laterality adds information about body side to the anatomic location, e.g. left

ShortLaterality
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..1
This element is affected by the following invariants: ele-1
TypeExtension(BodySite Qualifier) (Extension Type: CodeableConcept)
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
88. DeviceUseStatement.bodySite.extension:Laterality.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Shortxml:id (or equivalent in JSON)
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
90. DeviceUseStatement.bodySite.extension:Laterality.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, 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.

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..0
TypeExtension
Alternate Namesextensions, user content
SlicingThis element introduces a set of slices on DeviceUseStatement.bodySite.extension.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
92. DeviceUseStatement.bodySite.extension:Laterality.url
Definition

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

Shortidentifies the meaning of the extension
Comments

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

Control1..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed Value
{
  "url" : "http://nictiz.nl/fhir/StructureDefinition/BodySite-Qualifier"
}
<url value="http://nictiz.nl/fhir/StructureDefinition/BodySite-Qualifier"/>
94. DeviceUseStatement.bodySite.extension:Laterality.value[x]
Definition

Qualifier to refine the anatomical location. These include qualifiers for laterality, relative location, directionality, number, and plane.

ShortBodySite qualifier
Control0..1
BindingUnless not suitable, these codes SHALL be taken from MedischHulpmiddelLateraliteitCodelijst
(extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.10.1.4--20171231000000)

MedicalDeviceLateralityCodelist

TypeCodeableConcept
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
96. DeviceUseStatement.bodySite.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Control0..*
TypeCoding
Summarytrue
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

98. DeviceUseStatement.bodySite.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

ShortPlain text representation of the concept
Comments

Very often the text is the same as a displayName of one of the codings.

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

100. DeviceUseStatement.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
Must Supporttrue
102. DeviceUseStatement.note.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Shortxml:id (or equivalent in JSON)
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
104. DeviceUseStatement.note.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, 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.

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
Alternate Namesextensions, user content
SlicingThis element introduces a set of slices on DeviceUseStatement.note.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
106. DeviceUseStatement.note.author[x]
Definition

The individual responsible for making the annotation.

ShortIndividual responsible for the annotation
Control0..1
TypeChoice of: Reference(Practitioner, Patient, RelatedPerson), string
[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
108. DeviceUseStatement.note.time
Definition

Indicates when this particular annotation was made.

ShortWhen the annotation was made
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
110. DeviceUseStatement.note.text
Definition

Comment about use or information on the medical aid used.

ShortComment
Control1..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Alternate NamesToelichting