Patient Care Coordination (PCC) Implementation Guide
                
                0.1.1-current - ci-build
                    
                    
                    
  
                    
                    
            
            
Patient Care Coordination (PCC) Implementation Guide, published by Virtually Healthcare. This guide is not an authorized publication; it is the continuous build for version 0.1.1-current built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/Virtually-Healthcare/R4/ and changes regularly. See the Directory of published versions
| Official URL: https://fhir.virtually.healthcare/StructureDefinition/DetectedIssue | Version: 0.1.1-current | |||
| Draft as of 2025-08-14 | Computable Name: DetectedIssue | |||
TODO in discovery
Usages:
You can also check for usages in the FHIR IG Statistics
Description of Profiles, Differentials, Snapshots and how the different presentations work.
| Name | Flags | Card. | Type | Description & Constraints    Filter:  ![]() ![]()  | 
|---|---|---|---|---|
![]()  | 
0..* | DetectedIssue | Clinical issue with action | |
![]() ![]()  | 
?!Σ | 0..1 | uri | A set of rules under which this content was created | 
![]() ![]()  | 
?! | 0..* | Extension | Extensions that cannot be ignored | 
![]() ![]()  | 
?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Indicates the status of the identified issue.  | 
  Documentation for this format | ||||
| Path | Conformance | ValueSet | URI | 
| DetectedIssue.status | required | ObservationStatushttp://hl7.org/fhir/ValueSet/observation-status|4.0.1From the FHIR Standard  | 
| Id | Grade | Path(s) | Details | Requirements | 
| dom-2 | error | DetectedIssue | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()  | |
| dom-3 | error | DetectedIssue | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()  | |
| dom-4 | error | DetectedIssue | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()  | |
| dom-5 | error | DetectedIssue | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()  | |
| dom-6 | best practice | DetectedIssue | A resource should have narrative for robust management : text.`div`.exists()  | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())  | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists()  | 
This structure is derived from DetectedIssue
| Name | Flags | Card. | Type | Description & Constraints    Filter:  ![]() ![]()  | 
|---|---|---|---|---|
![]()  | 
0..* | DetectedIssue | Clinical issue with action | |
  Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints    Filter:  ![]() ![]()  | ||||
|---|---|---|---|---|---|---|---|---|
![]()  | 
0..* | DetectedIssue | Clinical issue with action | |||||
![]() ![]()  | 
Σ | 0..1 | id | Logical id of this artifact | ||||
![]() ![]()  | 
Σ | 0..1 | Meta | Metadata about the resource | ||||
![]() ![]()  | 
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
![]() ![]()  | 
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language. 
  | |||||
![]() ![]()  | 
0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements  | |||||
![]() ![]()  | 
0..* | Resource | Contained, inline Resources | |||||
![]() ![]()  | 
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]()  | 
?! | 0..* | Extension | Extensions that cannot be ignored | ||||
![]() ![]()  | 
Σ | 0..* | Identifier | Unique id for the detected issue | ||||
![]() ![]()  | 
?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Indicates the status of the identified issue.  | ||||
![]() ![]()  | 
Σ | 0..1 | CodeableConcept | Issue Category, e.g. drug-drug, duplicate therapy, etc. Binding: DetectedIssueCategory (preferred): Codes identifying the general type of detected issue; e.g. Drug-drug interaction, Timing issue, Duplicate therapy, etc.  | ||||
![]() ![]()  | 
Σ | 0..1 | code | high | moderate | low Binding: DetectedIssueSeverity (required): Indicates the potential degree of impact of the identified issue on the patient.  | ||||
![]() ![]()  | 
Σ | 0..1 | Reference(Patient) | Associated patient | ||||
![]() ![]()  | 
Σ | 0..1 | When identified | |||||
![]() ![]() ![]()  | 
dateTime | |||||||
![]() ![]() ![]()  | 
Period | |||||||
![]() ![]()  | 
Σ | 0..1 | Reference(Practitioner | PractitionerRole | Device) | The provider or device that identified the issue | ||||
![]() ![]()  | 
Σ | 0..* | Reference(Resource) | Problem resource | ||||
![]() ![]()  | 
0..* | BackboneElement | Supporting evidence | |||||
![]() ![]() ![]()  | 
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]()  | 
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]()  | 
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]()  | 
0..* | CodeableConcept | Manifestation Binding: ManifestationAndSymptomCodes (example): Codes that describes the types of evidence for a detected issue.  | |||||
![]() ![]() ![]()  | 
0..* | Reference(Resource) | Supporting information | |||||
![]() ![]()  | 
0..1 | string | Description and context | |||||
![]() ![]()  | 
0..1 | uri | Authority for issue | |||||
![]() ![]()  | 
0..* | BackboneElement | Step taken to address | |||||
![]() ![]() ![]()  | 
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]()  | 
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]()  | 
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]()  | 
1..1 | CodeableConcept | What mitigation? Binding: DetectedIssueMitigationAction (preferred): Codes describing steps taken to resolve the issue or other circumstances that mitigate the risk associated with the issue; e.g. 'added concurrent therapy', 'prior therapy documented', etc.  | |||||
![]() ![]() ![]()  | 
0..1 | dateTime | Date committed | |||||
![]() ![]() ![]()  | 
0..1 | Reference(Practitioner | PractitionerRole) | Who is committing? | |||||
  Documentation for this format | ||||||||
| Path | Conformance | ValueSet | URI | |||
| DetectedIssue.language | preferred | CommonLanguageshttp://hl7.org/fhir/ValueSet/languagesFrom the FHIR Standard 
  | ||||
| DetectedIssue.status | required | ObservationStatushttp://hl7.org/fhir/ValueSet/observation-status|4.0.1From the FHIR Standard  | ||||
| DetectedIssue.code | preferred | DetectedIssueCategoryhttp://hl7.org/fhir/ValueSet/detectedissue-categoryFrom the FHIR Standard  | ||||
| DetectedIssue.severity | required | DetectedIssueSeverityhttp://hl7.org/fhir/ValueSet/detectedissue-severity|4.0.1From the FHIR Standard  | ||||
| DetectedIssue.evidence.code | example | ManifestationAndSymptomCodeshttp://hl7.org/fhir/ValueSet/manifestation-or-symptomFrom the FHIR Standard  | ||||
| DetectedIssue.mitigation.action | preferred | DetectedIssueMitigationActionhttp://hl7.org/fhir/ValueSet/detectedissue-mitigation-actionFrom the FHIR Standard  | 
| Id | Grade | Path(s) | Details | Requirements | 
| dom-2 | error | DetectedIssue | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()  | |
| dom-3 | error | DetectedIssue | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()  | |
| dom-4 | error | DetectedIssue | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()  | |
| dom-5 | error | DetectedIssue | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()  | |
| dom-6 | best practice | DetectedIssue | A resource should have narrative for robust management : text.`div`.exists()  | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())  | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists()  | 
This structure is derived from DetectedIssue
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints    Filter:  ![]() ![]()  | 
|---|---|---|---|---|
![]()  | 
0..* | DetectedIssue | Clinical issue with action | |
![]() ![]()  | 
?!Σ | 0..1 | uri | A set of rules under which this content was created | 
![]() ![]()  | 
?! | 0..* | Extension | Extensions that cannot be ignored | 
![]() ![]()  | 
?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Indicates the status of the identified issue.  | 
  Documentation for this format | ||||
| Path | Conformance | ValueSet | URI | 
| DetectedIssue.status | required | ObservationStatushttp://hl7.org/fhir/ValueSet/observation-status|4.0.1From the FHIR Standard  | 
| Id | Grade | Path(s) | Details | Requirements | 
| dom-2 | error | DetectedIssue | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()  | |
| dom-3 | error | DetectedIssue | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()  | |
| dom-4 | error | DetectedIssue | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()  | |
| dom-5 | error | DetectedIssue | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()  | |
| dom-6 | best practice | DetectedIssue | A resource should have narrative for robust management : text.`div`.exists()  | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())  | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists()  | 
Differential View
This structure is derived from DetectedIssue
| Name | Flags | Card. | Type | Description & Constraints    Filter:  ![]() ![]()  | 
|---|---|---|---|---|
![]()  | 
0..* | DetectedIssue | Clinical issue with action | |
  Documentation for this format | ||||
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints    Filter:  ![]() ![]()  | ||||
|---|---|---|---|---|---|---|---|---|
![]()  | 
0..* | DetectedIssue | Clinical issue with action | |||||
![]() ![]()  | 
Σ | 0..1 | id | Logical id of this artifact | ||||
![]() ![]()  | 
Σ | 0..1 | Meta | Metadata about the resource | ||||
![]() ![]()  | 
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
![]() ![]()  | 
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language. 
  | |||||
![]() ![]()  | 
0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements  | |||||
![]() ![]()  | 
0..* | Resource | Contained, inline Resources | |||||
![]() ![]()  | 
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]()  | 
?! | 0..* | Extension | Extensions that cannot be ignored | ||||
![]() ![]()  | 
Σ | 0..* | Identifier | Unique id for the detected issue | ||||
![]() ![]()  | 
?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Indicates the status of the identified issue.  | ||||
![]() ![]()  | 
Σ | 0..1 | CodeableConcept | Issue Category, e.g. drug-drug, duplicate therapy, etc. Binding: DetectedIssueCategory (preferred): Codes identifying the general type of detected issue; e.g. Drug-drug interaction, Timing issue, Duplicate therapy, etc.  | ||||
![]() ![]()  | 
Σ | 0..1 | code | high | moderate | low Binding: DetectedIssueSeverity (required): Indicates the potential degree of impact of the identified issue on the patient.  | ||||
![]() ![]()  | 
Σ | 0..1 | Reference(Patient) | Associated patient | ||||
![]() ![]()  | 
Σ | 0..1 | When identified | |||||
![]() ![]() ![]()  | 
dateTime | |||||||
![]() ![]() ![]()  | 
Period | |||||||
![]() ![]()  | 
Σ | 0..1 | Reference(Practitioner | PractitionerRole | Device) | The provider or device that identified the issue | ||||
![]() ![]()  | 
Σ | 0..* | Reference(Resource) | Problem resource | ||||
![]() ![]()  | 
0..* | BackboneElement | Supporting evidence | |||||
![]() ![]() ![]()  | 
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]()  | 
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]()  | 
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]()  | 
0..* | CodeableConcept | Manifestation Binding: ManifestationAndSymptomCodes (example): Codes that describes the types of evidence for a detected issue.  | |||||
![]() ![]() ![]()  | 
0..* | Reference(Resource) | Supporting information | |||||
![]() ![]()  | 
0..1 | string | Description and context | |||||
![]() ![]()  | 
0..1 | uri | Authority for issue | |||||
![]() ![]()  | 
0..* | BackboneElement | Step taken to address | |||||
![]() ![]() ![]()  | 
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]()  | 
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]()  | 
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]()  | 
1..1 | CodeableConcept | What mitigation? Binding: DetectedIssueMitigationAction (preferred): Codes describing steps taken to resolve the issue or other circumstances that mitigate the risk associated with the issue; e.g. 'added concurrent therapy', 'prior therapy documented', etc.  | |||||
![]() ![]() ![]()  | 
0..1 | dateTime | Date committed | |||||
![]() ![]() ![]()  | 
0..1 | Reference(Practitioner | PractitionerRole) | Who is committing? | |||||
  Documentation for this format | ||||||||
| Path | Conformance | ValueSet | URI | |||
| DetectedIssue.language | preferred | CommonLanguageshttp://hl7.org/fhir/ValueSet/languagesFrom the FHIR Standard 
  | ||||
| DetectedIssue.status | required | ObservationStatushttp://hl7.org/fhir/ValueSet/observation-status|4.0.1From the FHIR Standard  | ||||
| DetectedIssue.code | preferred | DetectedIssueCategoryhttp://hl7.org/fhir/ValueSet/detectedissue-categoryFrom the FHIR Standard  | ||||
| DetectedIssue.severity | required | DetectedIssueSeverityhttp://hl7.org/fhir/ValueSet/detectedissue-severity|4.0.1From the FHIR Standard  | ||||
| DetectedIssue.evidence.code | example | ManifestationAndSymptomCodeshttp://hl7.org/fhir/ValueSet/manifestation-or-symptomFrom the FHIR Standard  | ||||
| DetectedIssue.mitigation.action | preferred | DetectedIssueMitigationActionhttp://hl7.org/fhir/ValueSet/detectedissue-mitigation-actionFrom the FHIR Standard  | 
| Id | Grade | Path(s) | Details | Requirements | 
| dom-2 | error | DetectedIssue | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()  | |
| dom-3 | error | DetectedIssue | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()  | |
| dom-4 | error | DetectedIssue | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()  | |
| dom-5 | error | DetectedIssue | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()  | |
| dom-6 | best practice | DetectedIssue | A resource should have narrative for robust management : text.`div`.exists()  | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())  | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists()  | 
This structure is derived from DetectedIssue
Other representations of profile: CSV, Excel, Schematron