HL7 Europe Hospital Discharge Report
1.0.0-ci - draft 150

HL7 Europe Hospital Discharge Report, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 1.0.0-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

Resource Profile: DeviceUseStatementEuHdr - Detailed Descriptions

Draft as of 2026-09-16

Definitions for the deviceUseStatement-eu-hdr resource profile.

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

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.

ShortRecord of use of a device
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id 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: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. 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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. 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
BindingThe codes SHOULD be taken from CommonLanguageshttp://hl7.org/fhir/ValueSet/languages|4.0.1
(preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Requirements

EHDSDeviceUse.header.language

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. DeviceUseStatement.text
Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

ShortDevice usage descriptionText 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 information is added later.

Control0..1
TypeNarrative
Is Modifierfalse
Summaryfalse
Alternate Namesnarrative, html, xhtml, display
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. 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 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. 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
Is Modifierfalse
Summarytrue
Requirements

EHDSDeviceUse.header.identifier

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. 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|4.0.1
(required to http://hl7.org/fhir/ValueSet/device-statement-status|4.0.1)

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

Typecode
Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

EHDSDeviceUse.header.status

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

The patient who used the device.

ShortPatient using device
Control1..1
TypeReference(Patient (EU core), Patient, Group)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. 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]
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

EHDSDeviceUse.periodOfUse

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on DeviceUseStatement.timing[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • type @ $this
  • 18. DeviceUseStatement.timing[x]:timingPeriod
    Slice NametimingPeriod
    Definition

    How often the device was used.

    ShortHow often the device was used
    Control0..1
    TypePeriod, dateTime, Timing
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. DeviceUseStatement.recordedOn
    Definition

    The time at which the statement was made/recorded.

    ShortWhen statement was recorded
    Control0..1
    TypedateTime
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    EHDSDeviceUse.header.date

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. DeviceUseStatement.source
    Definition

    Who reported the device was being used by the patient.

    ShortWho made the statement
    Control0..1
    TypeReference(Patient (EU core), Practitioner (EU core), PractitionerRole (EU core), RelatedPerson, Patient, Practitioner, PractitionerRole, RelatedPerson)
    Is Modifierfalse
    Summarytrue
    Requirements

    EHDSDeviceUse.header.author[x], EHDSDeviceUse.header.source

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. DeviceUseStatement.device
    Definition

    The details of the device used.

    ShortReference to device used
    Control1..1
    TypeReference(Device (HDR), Device)
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. DeviceUseStatement.reasonCode
    Definition

    Reason or justification for the use of the device.

    ShortWhy device was used
    Control0..*
    TypeCodeableConcept
    Is Modifierfalse
    Summarytrue
    Requirements

    EHDSDeviceUse.reason[x]

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. DeviceUseStatement.reasonReference
    Definition

    Indicates another resource whose existence justifies this DeviceUseStatement.

    ShortWhy was DeviceUseStatement performed?
    Control0..*
    TypeReference(Condition, Observation, DiagnosticReport, DocumentReference, Media)
    Is Modifierfalse
    Summarytrue
    Requirements

    EHDSDeviceUse.reason[x]

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. DeviceUseStatement.bodySite
    Definition

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

    ShortTarget body site
    Control0..1
    BindingThe codes SHOULD be taken from For example codes, see SNOMEDCTBodyStructureshttp://hl7.org/fhir/ValueSet/body-site|4.0.1
    (preferred to http://hl7.org/fhir/ValueSet/body-site)
    TypeCodeableConcept
    Is Modifierfalse
    Summarytrue
    Requirements

    EHDSDeviceUse.bodySite


    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/bodySite.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    dus-hdr-1: Either a body site code or a reference to a BodyStructure resource SHALL be used, but not both. ((coding.empty() and text.empty()) or extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-DeviceUsage.bodySite').empty())
    32. DeviceUseStatement.bodySite.extension:bodySite
    Slice NamebodySite
    Definition

    R5: DeviceUsage.bodySite additional types (CodeableReference(http://hl7.org/fhir/StructureDefinition/BodyStructure)) additional types from child elements (reference)

    ShortBody site, when laterality or qualifiers cannot be pre-coordinated in bodySite
    Comments

    Element DeviceUsage.bodySite is mapped to FHIR R4 element DeviceUseStatement.bodySite as SourceIsBroaderThanTarget. The mappings for DeviceUsage.bodySite do not cover the following types: CodeableReference. The mappings for DeviceUsage.bodySite do not cover the following types based on type expansion: reference.

    Control0..1
    TypeExtension(R5: bodySite additional types) (Extension Type: Reference(Cross-version Profile for R5.BodyStructure for use in FHIR R4, BodyStructure))
    Is Modifierfalse
    Summaryfalse
    Requirements

    EHDSDeviceUse.bodySite

    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())
    34. DeviceUseStatement.bodySite.extension:bodySite.extension
    Definition

    An Extension


    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.

    ShortExtensionAdditional 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
    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())
    ele-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 DeviceUseStatement.bodySite.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 36. DeviceUseStatement.bodySite.extension:bodySite.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
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-DeviceUsage.bodySite
      38. DeviceUseStatement.bodySite.extension:bodySite.value[x]
      Definition

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


      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      ShortTarget body siteValue of extension
      Control0..1
      TypeReference(BodyStructure (EU core)), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. 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
      Is Modifierfalse
      Summaryfalse
      Requirements

      EHDSDeviceUse.note

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

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

      0. DeviceUseStatement
      2. DeviceUseStatement.language
      Requirements

      EHDSDeviceUse.header.language

      4. DeviceUseStatement.text
      ShortDevice usage description
      6. DeviceUseStatement.identifier
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Requirements

      EHDSDeviceUse.header.identifier

      8. DeviceUseStatement.status
      Requirements

      EHDSDeviceUse.header.status

      10. DeviceUseStatement.subject
      TypeReference(Patient (EU core))
      12. DeviceUseStatement.timing[x]
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Requirements

      EHDSDeviceUse.periodOfUse

      SlicingThis element introduces a set of slices on DeviceUseStatement.timing[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • type @ $this
      • 14. DeviceUseStatement.timing[x]:timingPeriod
        Slice NametimingPeriod
        Control0..1
        TypePeriod
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        16. DeviceUseStatement.recordedOn
        Requirements

        EHDSDeviceUse.header.date

        18. DeviceUseStatement.source
        TypeReference(Patient (EU core), Practitioner (EU core), PractitionerRole (EU core), RelatedPerson)
        Requirements

        EHDSDeviceUse.header.author[x], EHDSDeviceUse.header.source

        20. DeviceUseStatement.device
        TypeReference(Device (HDR))
        22. DeviceUseStatement.reasonCode
        Requirements

        EHDSDeviceUse.reason[x]

        24. DeviceUseStatement.reasonReference
        Requirements

        EHDSDeviceUse.reason[x]

        26. DeviceUseStatement.bodySite
        BindingThe codes SHOULD be taken from SNOMEDCTBodyStructures
        (preferred to http://hl7.org/fhir/ValueSet/body-site)
        Requirements

        EHDSDeviceUse.bodySite

        Invariantsdus-hdr-1: Either a body site code or a reference to a BodyStructure resource SHALL be used, but not both. ((coding.empty() and text.empty()) or extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-DeviceUsage.bodySite').empty())
        28. DeviceUseStatement.bodySite.extension:bodySite
        Slice NamebodySite
        ShortBody site, when laterality or qualifiers cannot be pre-coordinated in bodySite
        Control0..1
        TypeExtension(R5: bodySite additional types) (Extension Type: Reference(Cross-version Profile for R5.BodyStructure for use in FHIR R4, BodyStructure))
        Requirements

        EHDSDeviceUse.bodySite

        30. DeviceUseStatement.bodySite.extension:bodySite.extension
        Control0..0
        32. DeviceUseStatement.bodySite.extension:bodySite.value[x]
        TypeReference(BodyStructure (EU core))
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        34. DeviceUseStatement.note
        Requirements

        EHDSDeviceUse.note

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

        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.

        ShortRecord of use of a device
        Control0..*
        Is Modifierfalse
        Summaryfalse
        Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
        dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id 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: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
        dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
        dom-6: A resource should have narrative for robust management (text.`div`.exists())
        2. 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
        Is Modifierfalse
        Summarytrue
        4. DeviceUseStatement.meta
        Definition

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

        ShortMetadata about the resource
        Control0..1
        TypeMeta
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

        ShortA set of rules under which this content was created
        Comments

        Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

        Control0..1
        Typeuri
        Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        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
        BindingThe codes SHOULD be taken from CommonLanguages
        (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

        A human language.

        Additional BindingsPurpose
        AllLanguagesMax Binding
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Requirements

        EHDSDeviceUse.header.language

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        10. DeviceUseStatement.text
        Definition

        A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

        ShortDevice usage description
        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 information is added later.

        Control0..1
        TypeNarrative
        Is Modifierfalse
        Summaryfalse
        Alternate Namesnarrative, html, xhtml, display
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

        Control0..*
        TypeResource
        Is Modifierfalse
        Summaryfalse
        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. 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())
        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 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Summaryfalse
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        18. 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
        Is Modifierfalse
        Summarytrue
        Requirements

        EHDSDeviceUse.header.identifier

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

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

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

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

        Alternate Namesfulfills
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. 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|4.0.1)

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

        Typecode
        Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        EHDSDeviceUse.header.status

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. DeviceUseStatement.subject
        Definition

        The patient who used the device.

        ShortPatient using device
        Control1..1
        TypeReference(Patient (EU core))
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. DeviceUseStatement.derivedFrom
        Definition

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

        ShortSupporting information
        Comments

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

        Control0..*
        TypeReference(ServiceRequest, Procedure, Claim, Observation, QuestionnaireResponse, DocumentReference)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. 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]
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        EHDSDeviceUse.periodOfUse

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on DeviceUseStatement.timing[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • type @ $this
        • 30. DeviceUseStatement.timing[x]:timingPeriod
          Slice NametimingPeriod
          Definition

          How often the device was used.

          ShortHow often the device was used
          Control0..1
          TypePeriod
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          32. DeviceUseStatement.recordedOn
          Definition

          The time at which the statement was made/recorded.

          ShortWhen statement was recorded
          Control0..1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          EHDSDeviceUse.header.date

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

          Who reported the device was being used by the patient.

          ShortWho made the statement
          Control0..1
          TypeReference(Patient (EU core), Practitioner (EU core), PractitionerRole (EU core), RelatedPerson)
          Is Modifierfalse
          Summarytrue
          Requirements

          EHDSDeviceUse.header.author[x], EHDSDeviceUse.header.source

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

          The details of the device used.

          ShortReference to device used
          Control1..1
          TypeReference(Device (HDR))
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          38. DeviceUseStatement.reasonCode
          Definition

          Reason or justification for the use of the device.

          ShortWhy device was used
          Control0..*
          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Requirements

          EHDSDeviceUse.reason[x]

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          40. DeviceUseStatement.reasonReference
          Definition

          Indicates another resource whose existence justifies this DeviceUseStatement.

          ShortWhy was DeviceUseStatement performed?
          Control0..*
          TypeReference(Condition, Observation, DiagnosticReport, DocumentReference, Media)
          Is Modifierfalse
          Summarytrue
          Requirements

          EHDSDeviceUse.reason[x]

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          42. DeviceUseStatement.bodySite
          Definition

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

          ShortTarget body site
          Control0..1
          BindingThe codes SHOULD be taken from SNOMEDCTBodyStructures
          (preferred to http://hl7.org/fhir/ValueSet/body-site)
          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Requirements

          EHDSDeviceUse.bodySite

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          dus-hdr-1: Either a body site code or a reference to a BodyStructure resource SHALL be used, but not both. ((coding.empty() and text.empty()) or extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-DeviceUsage.bodySite').empty())
          44. 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.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          46. DeviceUseStatement.bodySite.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 DeviceUseStatement.bodySite.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 48. DeviceUseStatement.bodySite.extension:bodySite
            Slice NamebodySite
            Definition

            R5: DeviceUsage.bodySite additional types (CodeableReference(http://hl7.org/fhir/StructureDefinition/BodyStructure)) additional types from child elements (reference)

            ShortBody site, when laterality or qualifiers cannot be pre-coordinated in bodySite
            Comments

            Element DeviceUsage.bodySite is mapped to FHIR R4 element DeviceUseStatement.bodySite as SourceIsBroaderThanTarget. The mappings for DeviceUsage.bodySite do not cover the following types: CodeableReference. The mappings for DeviceUsage.bodySite do not cover the following types based on type expansion: reference.

            Control0..1
            TypeExtension(R5: bodySite additional types) (Extension Type: Reference(Cross-version Profile for R5.BodyStructure for use in FHIR R4, BodyStructure))
            Is Modifierfalse
            Summaryfalse
            Requirements

            EHDSDeviceUse.bodySite

            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())
            50. DeviceUseStatement.bodySite.extension: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.

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            52. DeviceUseStatement.bodySite.extension:bodySite.extension
            Definition

            An Extension

            ShortExtension
            Control0..0
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            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 DeviceUseStatement.bodySite.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 54. DeviceUseStatement.bodySite.extension:bodySite.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
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-DeviceUsage.bodySite
              56. DeviceUseStatement.bodySite.extension:bodySite.value[x]
              Definition

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

              ShortTarget body site
              Control0..1
              TypeReference(BodyStructure (EU core))
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              58. 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
              Is Modifierfalse
              Summarytrue
              Requirements

              Allows for alternative encodings within a code system, and translations to other code systems.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              60. 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
              Is Modifierfalse
              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.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              62. 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
              Is Modifierfalse
              Summaryfalse
              Requirements

              EHDSDeviceUse.note

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