HL7 Europe Hospital Discharge Report
0.0.1-ci - ci-build 150

HL7 Europe Hospital Discharge Report, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 0.0.1-ci built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/hdr/ and changes regularly. See the Directory of published versions

Logical Model: RecommendationsEhn - Detailed Descriptions

Draft as of 2024-11-06

Definitions for the Recommendations logical model.

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

0. Recommendations
Definition

Hospital Discharge Report - Care plan and other recommendations after discharge - A.2.9 eHN

ShortA.2.9 - Care plan and other recommendations after discharge (eHN)
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. Recommendations.carePlan
Definition

Care plan after discharge. Multiple care plans could be provided.

ShortA.2.9.1 - Care plan
Control0..*
TypeBackboneElement
4. Recommendations.carePlan.title
Definition

Human-friendly name for the care plan (e.g. Hip replacement care plan)

ShortA.2.9.1.1 - Title
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
6. Recommendations.carePlan.addresses
Definition

Identifies the conditions/problems/concerns/diagnoses/etc. whose management and/or mitigation are handled by this plan. This element provides a linkage to the conditions recorded in the diagnostic summary section.

ShortA.2.9.1.2 - Addresses
Control0..*
TypeCodeableConcept
8. Recommendations.carePlan.description
Definition

A description of the scope and nature of the plan.

ShortA.2.9.1.3 - Description
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
10. Recommendations.carePlan.planPeriod
Definition

Indicates when the plan did (or is intended to) come into effect and end.

ShortA.2.9.1.4 - Plan Period
Control0..1
TypePeriod
12. Recommendations.carePlan.details
Definition

Other structured and coded details, care team, goals to be achieved.

ShortA.2.9.1.5 - Other details
Control0..*
TypeBackboneElement
14. Recommendations.carePlan.activity
Definition

Actions to occur as part of the plan.

ShortA.2.9.1.6 - Activity
Control0..*
TypeBackboneElement
16. Recommendations.carePlan.activity.kind
Definition

A description of the type of care plan activity. For example, a MedicationRequest, a ServiceRequest, or a CommunicationRequest.

ShortA.2.9.1.6.1 - Kind
Control0..1
TypeCodeableConcept
18. Recommendations.carePlan.activity.description
Definition

A detailed description of the activity.

ShortA.2.9.1.6.2 - Activity description
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
20. Recommendations.carePlan.activity.attribute
Definition

Specific structured attributes per each activity type expressed by the Activity kind element, E.g., specific attributes for prescription request, appointment, etc.

ShortA.2.9.1.6.3 - Specific attributes
Control0..*
TypeBackboneElement
22. Recommendations.medicationSummary
Definition

Summary information on the medication recommended for the period after discharge, indicating whether the medication is changed or newly started. Compared to previous practices, the overview is supplemented with medication that has been discontinued.

ShortA.2.9.2 - Medication summary
Control1..*
TypeBackboneElement
24. Recommendations.medicationSummary.reason
Definition

The reason why the medication is or was prescribed or used. It provides a link to the Past or current health condition(s) or problem(s) that the patient has had or has and for which this medication was prescribed.

ShortA.2.9.2.1 - Medication reason
Control0..*
TypeCodeableConcept
26. Recommendations.medicationSummary.changeReason
Definition

Reason for change of medication

ShortA.2.9.2.2 - Reason for change
Control0..1
TypeCodeableConcept
28. Recommendations.medicationSummary.productCode
Definition

Product code.

ShortA.2.9.2.3 - Code
Control1..1
TypeCodeableConcept
30. Recommendations.medicationSummary.productName
Definition

Brand name if biological medicinal product or when justified by the health professional (ref. Commission Directive 2012/52/EU)

ShortA.2.9.2.4 - Brand name
Control1..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
32. Recommendations.medicationSummary.activeIngredient
Definition

Substance that alone or in combination with one or more other ingredients produces the intended activity of a medicinal product. Example: 'paracetamol'

ShortA.2.9.2.5 - Active ingredient list
Control0..*
TypeCodeableConcept
34. Recommendations.medicationSummary.strength
Definition

The content of the active ingredient expressed quantifiably per dosage unit, per unit of volume or per unit of weight, according to the pharmaceutical dose form. Example: 500 mg per tablet

ShortA.2.9.2.6 - Strength
Control0..*
TypeRatio
36. Recommendations.medicationSummary.doseForm
Definition

The form in which a pharmaceutical product is presented in the medicinal product package (e.g. tablet, syrup)

ShortA.2.9.2.7 - Pharmaceutical dose form
Control0..1
TypeCodeableConcept
38. Recommendations.medicationSummary.dosageRegimen
Definition

Number of units per intake and frequency of intake over a specified duration of time. Example: 1 tablet every 24h, for 10 days

ShortA.2.9.2.8 - Dosage Regimen
Control0..*
TypeBackboneElement
40. Recommendations.medicationSummary.route
Definition

Path by which the pharmaceutical product is taken into or makes contact with the body.

ShortA.2.9.2.9 - Route of administration
Control0..1
TypeCodeableConcept
42. Recommendations.medicationSummary.period
Definition

The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking).

ShortA.2.9.2.10 - Period of treatment
Control0..1
TypePeriod
44. Recommendations.medicationSummary.daysSupplied
Definition

Number of days for which the patient was provided with the drug. Supply is intended to either hand over the medicine or write out a prescription. A 0 value indicates that the patient has not been provided with the drug (e.g. if the patient has a sufficient supply of the drug)

ShortA.2.9.2.11 - Days supplied
Control1..1
TypeBackboneElement
46. Recommendations.Recommendations
Definition

Other recommendations (advice) after discharge. Multiple recommendations could be provided. E.g., recommendation to suggest hip replacement, reduce number of cigarettes, stop smoking, increase physical exercises, etc.

ShortA.2.9.3 - Other recommendations
Control0..*
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension

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

0. Recommendations
Definition

Hospital Discharge Report - Care plan and other recommendations after discharge - A.2.9 eHN

ShortA.2.9 - Care plan and other recommendations after discharge (eHN)
Control0..*
Is Modifierfalse
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. Recommendations.carePlan
Definition

Care plan after discharge. Multiple care plans could be provided.

ShortA.2.9.1 - Care plan
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Recommendations.carePlan.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 manageable, 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()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Recommendations.carePlan.title
Definition

Human-friendly name for the care plan (e.g. Hip replacement care plan)

ShortA.2.9.1.1 - Title
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
8. Recommendations.carePlan.addresses
Definition

Identifies the conditions/problems/concerns/diagnoses/etc. whose management and/or mitigation are handled by this plan. This element provides a linkage to the conditions recorded in the diagnostic summary section.

ShortA.2.9.1.2 - Addresses
Control0..*
TypeCodeableConcept
10. Recommendations.carePlan.description
Definition

A description of the scope and nature of the plan.

ShortA.2.9.1.3 - Description
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
12. Recommendations.carePlan.planPeriod
Definition

Indicates when the plan did (or is intended to) come into effect and end.

ShortA.2.9.1.4 - Plan Period
Control0..1
TypePeriod
14. Recommendations.carePlan.details
Definition

Other structured and coded details, care team, goals to be achieved.

ShortA.2.9.1.5 - Other details
Control0..*
TypeBackboneElement
16. Recommendations.carePlan.activity
Definition

Actions to occur as part of the plan.

ShortA.2.9.1.6 - Activity
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. Recommendations.carePlan.activity.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 manageable, 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()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
20. Recommendations.carePlan.activity.kind
Definition

A description of the type of care plan activity. For example, a MedicationRequest, a ServiceRequest, or a CommunicationRequest.

ShortA.2.9.1.6.1 - Kind
Control0..1
TypeCodeableConcept
22. Recommendations.carePlan.activity.description
Definition

A detailed description of the activity.

ShortA.2.9.1.6.2 - Activity description
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
24. Recommendations.carePlan.activity.attribute
Definition

Specific structured attributes per each activity type expressed by the Activity kind element, E.g., specific attributes for prescription request, appointment, etc.

ShortA.2.9.1.6.3 - Specific attributes
Control0..*
TypeBackboneElement
26. Recommendations.medicationSummary
Definition

Summary information on the medication recommended for the period after discharge, indicating whether the medication is changed or newly started. Compared to previous practices, the overview is supplemented with medication that has been discontinued.

ShortA.2.9.2 - Medication summary
Control1..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Recommendations.medicationSummary.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 manageable, 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()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
30. Recommendations.medicationSummary.reason
Definition

The reason why the medication is or was prescribed or used. It provides a link to the Past or current health condition(s) or problem(s) that the patient has had or has and for which this medication was prescribed.

ShortA.2.9.2.1 - Medication reason
Control0..*
TypeCodeableConcept
32. Recommendations.medicationSummary.changeReason
Definition

Reason for change of medication

ShortA.2.9.2.2 - Reason for change
Control0..1
TypeCodeableConcept
34. Recommendations.medicationSummary.productCode
Definition

Product code.

ShortA.2.9.2.3 - Code
Control1..1
TypeCodeableConcept
36. Recommendations.medicationSummary.productName
Definition

Brand name if biological medicinal product or when justified by the health professional (ref. Commission Directive 2012/52/EU)

ShortA.2.9.2.4 - Brand name
Control1..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
38. Recommendations.medicationSummary.activeIngredient
Definition

Substance that alone or in combination with one or more other ingredients produces the intended activity of a medicinal product. Example: 'paracetamol'

ShortA.2.9.2.5 - Active ingredient list
Control0..*
TypeCodeableConcept
40. Recommendations.medicationSummary.strength
Definition

The content of the active ingredient expressed quantifiably per dosage unit, per unit of volume or per unit of weight, according to the pharmaceutical dose form. Example: 500 mg per tablet

ShortA.2.9.2.6 - Strength
Control0..*
TypeRatio
42. Recommendations.medicationSummary.doseForm
Definition

The form in which a pharmaceutical product is presented in the medicinal product package (e.g. tablet, syrup)

ShortA.2.9.2.7 - Pharmaceutical dose form
Control0..1
TypeCodeableConcept
44. Recommendations.medicationSummary.dosageRegimen
Definition

Number of units per intake and frequency of intake over a specified duration of time. Example: 1 tablet every 24h, for 10 days

ShortA.2.9.2.8 - Dosage Regimen
Control0..*
TypeBackboneElement
46. Recommendations.medicationSummary.route
Definition

Path by which the pharmaceutical product is taken into or makes contact with the body.

ShortA.2.9.2.9 - Route of administration
Control0..1
TypeCodeableConcept
48. Recommendations.medicationSummary.period
Definition

The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking).

ShortA.2.9.2.10 - Period of treatment
Control0..1
TypePeriod
50. Recommendations.medicationSummary.daysSupplied
Definition

Number of days for which the patient was provided with the drug. Supply is intended to either hand over the medicine or write out a prescription. A 0 value indicates that the patient has not been provided with the drug (e.g. if the patient has a sufficient supply of the drug)

ShortA.2.9.2.11 - Days supplied
Control1..1
TypeBackboneElement
52. Recommendations.Recommendations
Definition

Other recommendations (advice) after discharge. Multiple recommendations could be provided. E.g., recommendation to suggest hip replacement, reduce number of cigarettes, stop smoking, increase physical exercises, etc.

ShortA.2.9.3 - Other recommendations
Control0..*
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension

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

0. Recommendations
Definition

Hospital Discharge Report - Care plan and other recommendations after discharge - A.2.9 eHN

ShortA.2.9 - Care plan and other recommendations after discharge (eHN)
Control0..*
Is Modifierfalse
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. Recommendations.carePlan
Definition

Care plan after discharge. Multiple care plans could be provided.

ShortA.2.9.1 - Care plan
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Recommendations.carePlan.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
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
6. Recommendations.carePlan.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 manageable, 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()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Recommendations.carePlan.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 8. Recommendations.carePlan.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 manageable, 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()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    10. Recommendations.carePlan.title
    Definition

    Human-friendly name for the care plan (e.g. Hip replacement care plan)

    ShortA.2.9.1.1 - Title
    Control0..1
    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    12. Recommendations.carePlan.addresses
    Definition

    Identifies the conditions/problems/concerns/diagnoses/etc. whose management and/or mitigation are handled by this plan. This element provides a linkage to the conditions recorded in the diagnostic summary section.

    ShortA.2.9.1.2 - Addresses
    Control0..*
    TypeCodeableConcept
    14. Recommendations.carePlan.description
    Definition

    A description of the scope and nature of the plan.

    ShortA.2.9.1.3 - Description
    Control0..1
    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    16. Recommendations.carePlan.planPeriod
    Definition

    Indicates when the plan did (or is intended to) come into effect and end.

    ShortA.2.9.1.4 - Plan Period
    Control0..1
    TypePeriod
    18. Recommendations.carePlan.details
    Definition

    Other structured and coded details, care team, goals to be achieved.

    ShortA.2.9.1.5 - Other details
    Control0..*
    TypeBackboneElement
    20. Recommendations.carePlan.activity
    Definition

    Actions to occur as part of the plan.

    ShortA.2.9.1.6 - Activity
    Control0..*
    TypeBackboneElement
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. Recommendations.carePlan.activity.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
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    24. Recommendations.carePlan.activity.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 manageable, 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()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on Recommendations.carePlan.activity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 26. Recommendations.carePlan.activity.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 manageable, 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()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      28. Recommendations.carePlan.activity.kind
      Definition

      A description of the type of care plan activity. For example, a MedicationRequest, a ServiceRequest, or a CommunicationRequest.

      ShortA.2.9.1.6.1 - Kind
      Control0..1
      TypeCodeableConcept
      30. Recommendations.carePlan.activity.description
      Definition

      A detailed description of the activity.

      ShortA.2.9.1.6.2 - Activity description
      Control0..1
      Typestring
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      32. Recommendations.carePlan.activity.attribute
      Definition

      Specific structured attributes per each activity type expressed by the Activity kind element, E.g., specific attributes for prescription request, appointment, etc.

      ShortA.2.9.1.6.3 - Specific attributes
      Control0..*
      TypeBackboneElement
      34. Recommendations.medicationSummary
      Definition

      Summary information on the medication recommended for the period after discharge, indicating whether the medication is changed or newly started. Compared to previous practices, the overview is supplemented with medication that has been discontinued.

      ShortA.2.9.2 - Medication summary
      Control1..*
      TypeBackboneElement
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. Recommendations.medicationSummary.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
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      38. Recommendations.medicationSummary.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 manageable, 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()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Recommendations.medicationSummary.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 40. Recommendations.medicationSummary.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 manageable, 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()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        42. Recommendations.medicationSummary.reason
        Definition

        The reason why the medication is or was prescribed or used. It provides a link to the Past or current health condition(s) or problem(s) that the patient has had or has and for which this medication was prescribed.

        ShortA.2.9.2.1 - Medication reason
        Control0..*
        TypeCodeableConcept
        44. Recommendations.medicationSummary.changeReason
        Definition

        Reason for change of medication

        ShortA.2.9.2.2 - Reason for change
        Control0..1
        TypeCodeableConcept
        46. Recommendations.medicationSummary.productCode
        Definition

        Product code.

        ShortA.2.9.2.3 - Code
        Control1..1
        TypeCodeableConcept
        48. Recommendations.medicationSummary.productName
        Definition

        Brand name if biological medicinal product or when justified by the health professional (ref. Commission Directive 2012/52/EU)

        ShortA.2.9.2.4 - Brand name
        Control1..1
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        50. Recommendations.medicationSummary.activeIngredient
        Definition

        Substance that alone or in combination with one or more other ingredients produces the intended activity of a medicinal product. Example: 'paracetamol'

        ShortA.2.9.2.5 - Active ingredient list
        Control0..*
        TypeCodeableConcept
        52. Recommendations.medicationSummary.strength
        Definition

        The content of the active ingredient expressed quantifiably per dosage unit, per unit of volume or per unit of weight, according to the pharmaceutical dose form. Example: 500 mg per tablet

        ShortA.2.9.2.6 - Strength
        Control0..*
        TypeRatio
        54. Recommendations.medicationSummary.doseForm
        Definition

        The form in which a pharmaceutical product is presented in the medicinal product package (e.g. tablet, syrup)

        ShortA.2.9.2.7 - Pharmaceutical dose form
        Control0..1
        TypeCodeableConcept
        56. Recommendations.medicationSummary.dosageRegimen
        Definition

        Number of units per intake and frequency of intake over a specified duration of time. Example: 1 tablet every 24h, for 10 days

        ShortA.2.9.2.8 - Dosage Regimen
        Control0..*
        TypeBackboneElement
        58. Recommendations.medicationSummary.route
        Definition

        Path by which the pharmaceutical product is taken into or makes contact with the body.

        ShortA.2.9.2.9 - Route of administration
        Control0..1
        TypeCodeableConcept
        60. Recommendations.medicationSummary.period
        Definition

        The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking).

        ShortA.2.9.2.10 - Period of treatment
        Control0..1
        TypePeriod
        62. Recommendations.medicationSummary.daysSupplied
        Definition

        Number of days for which the patient was provided with the drug. Supply is intended to either hand over the medicine or write out a prescription. A 0 value indicates that the patient has not been provided with the drug (e.g. if the patient has a sufficient supply of the drug)

        ShortA.2.9.2.11 - Days supplied
        Control1..1
        TypeBackboneElement
        64. Recommendations.Recommendations
        Definition

        Other recommendations (advice) after discharge. Multiple recommendations could be provided. E.g., recommendation to suggest hip replacement, reduce number of cigarettes, stop smoking, increase physical exercises, etc.

        ShortA.2.9.3 - Other recommendations
        Control0..*
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension