HL7 Europe Hospital Discharge Report
1.0.0-alpha - qa-preview 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-alpha 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: DeviceUseStatementEuHdrObligation - Detailed Descriptions

Page standards status: Informative Maturity Level: 0

Definitions for the deviceUseStatement-obl-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.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
Obligations
    ObligationsActor
    SHALL:handleHDRConsumer
    SHALL:able-to-populateHDRCreator
    Summaryfalse
    Alternate Namesnarrative, html, xhtml, display
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    6. 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())
    8. 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.

    ShortCurrent status of the Device Usageactive | 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
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    10. DeviceUseStatement.subject
    Definition

    The patient using the device.


    The patient who used the device.

    ShortPatient using device
    Control1..1
    TypeReference(Patient (EU core), Patient, Group)
    Is Modifierfalse
    Obligations
      ObligationsActor
      SHALL:handleHDRConsumer
      SHALL:able-to-populateHDRCreator
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. DeviceUseStatement.subject.reference
      Definition

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

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

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

      Control10..1
      This element is affected by the following invariants: ref-1
      Typestring
      Is Modifierfalse
      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()))
      14. DeviceUseStatement.timing[x]
      Definition

      How often the device was used.

      ShortHow often the device was used
      Control10..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
      Obligations
        ObligationsActor
        SHALL:handleHDRConsumer
        SHALL:able-to-populateHDRCreator
        Summarytrue
        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 Closed, and can be differentiated using the following discriminators:
        • type @ $this
        • 16. 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()))
          18. DeviceUseStatement.device
          Definition

          The details of the device used.

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

            Reason or justification for the use of the device.

            ShortWhy is used (code)Why device was used
            Control0..*
            TypeCodeableConcept
            Is Modifierfalse
            Obligations
              ObligationsActor
              SHALL:handleHDRConsumer
              MAY:able-to-populateHDRCreator
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              22. 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
              Obligations
                ObligationsActor
                SHALL:handleHDRConsumer
                MAY:able-to-populateHDRCreator
                Summarytrue
                Requirements

                Knowing where the device is targeted is important for tracking if multiple sites are possible. If more information than just a code is required, use the extension http://hl7.org/fhir/StructureDefinition/bodySite.

                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.text
                Obligations
                  ObligationsActor
                  SHALL:handleHDRConsumer
                  SHALL:able-to-populateHDRCreator
                  4. DeviceUseStatement.subject
                  Obligations
                    ObligationsActor
                    SHALL:handleHDRConsumer
                    SHALL:able-to-populateHDRCreator
                    6. DeviceUseStatement.timing[x]
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Obligations
                      ObligationsActor
                      SHALL:handleHDRConsumer
                      SHALL:able-to-populateHDRCreator
                      8. DeviceUseStatement.device
                      Obligations
                        ObligationsActor
                        SHALL:handleHDRConsumer
                        SHOULD:able-to-populateHDRCreator
                        10. DeviceUseStatement.reasonCode
                        Obligations
                          ObligationsActor
                          SHALL:handleHDRConsumer
                          MAY:able-to-populateHDRCreator
                          12. DeviceUseStatement.bodySite
                          Obligations
                            ObligationsActor
                            SHALL:handleHDRConsumer
                            MAY:able-to-populateHDRCreator

                            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
                            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
                            Obligations
                              ObligationsActor
                              SHALL:handleHDRConsumer
                              SHALL:able-to-populateHDRCreator
                              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.

                              ShortDevice usage identifier
                              NoteThis is a business identifier, not a resource identifier (see discussion)
                              Control0..*
                              TypeIdentifier
                              Is Modifierfalse
                              Summarytrue
                              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.

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

                              The patient using the device.

                              ShortPatient using device
                              Control1..1
                              TypeReference(Patient (EU core))
                              Is Modifierfalse
                              Obligations
                                ObligationsActor
                                SHALL:handleHDRConsumer
                                SHALL:able-to-populateHDRCreator
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                26. DeviceUseStatement.subject.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
                                28. DeviceUseStatement.subject.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.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 30. DeviceUseStatement.subject.reference
                                  Definition

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

                                  ShortLiteral reference, Relative, internal or absolute URL
                                  Comments

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

                                  Control1..1
                                  This element is affected by the following invariants: ref-1
                                  Typestring
                                  Is Modifierfalse
                                  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()))
                                  32. DeviceUseStatement.subject.type
                                  Definition

                                  The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                  The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                  ShortType the reference refers to (e.g. "Patient")
                                  Comments

                                  This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                  Control0..1
                                  BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                  (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

                                  Aa resource (or, for logical models, the URI of the logical model).

                                  Typeuri
                                  Is Modifierfalse
                                  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()))
                                  34. DeviceUseStatement.subject.identifier
                                  Definition

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

                                  ShortLogical reference, when literal reference is not known
                                  Comments

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

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

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

                                  Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                  Control0..1
                                  TypeIdentifier
                                  Is Modifierfalse
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  36. DeviceUseStatement.subject.display
                                  Definition

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

                                  ShortText alternative for the resource
                                  Comments

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

                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  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()))
                                  38. 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()))
                                  40. DeviceUseStatement.timing[x]
                                  Definition

                                  How often the device was used.

                                  ShortHow often the device was used
                                  Control1..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
                                  Obligations
                                    ObligationsActor
                                    SHALL:handleHDRConsumer
                                    SHALL:able-to-populateHDRCreator
                                    Summarytrue
                                    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 Closed, and can be differentiated using the following discriminators:
                                    • type @ $this
                                    • 42. 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()))
                                      44. DeviceUseStatement.timing[x]:timingPeriod.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.timing[x]:timingPeriod.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.timing[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 48. DeviceUseStatement.timing[x]:timingPeriod.start
                                        Definition

                                        The start of the period. The boundary is inclusive.

                                        ShortStart of usage (dateTime)
                                        Comments

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

                                        Control0..1
                                        This element is affected by the following invariants: per-1
                                        TypedateTime
                                        Is Modifierfalse
                                        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()))
                                        50. DeviceUseStatement.timing[x]:timingPeriod.end
                                        Definition

                                        The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                                        ShortEnd of usage (dateTime)
                                        Comments

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

                                        Control0..1
                                        This element is affected by the following invariants: per-1
                                        TypedateTime
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        52. DeviceUseStatement.recordedOn
                                        Definition

                                        The time at which the statement was made/recorded.

                                        ShortWhen recorded (dateTime)
                                        Control0..1
                                        TypedateTime
                                        Is Modifierfalse
                                        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()))
                                        54. 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
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        56. DeviceUseStatement.device
                                        Definition

                                        The details of the device used.

                                        ShortReference to device used
                                        Control1..1
                                        TypeReference(Device (HDR))
                                        Is Modifierfalse
                                        Obligations
                                          ObligationsActor
                                          SHALL:handleHDRConsumer
                                          SHOULD:able-to-populateHDRCreator
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          58. DeviceUseStatement.reasonCode
                                          Definition

                                          Reason or justification for the use of the device.

                                          ShortWhy is used (code)
                                          Control0..*
                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Obligations
                                            ObligationsActor
                                            SHALL:handleHDRConsumer
                                            MAY:able-to-populateHDRCreator
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            60. DeviceUseStatement.reasonReference
                                            Definition

                                            Indicates another resource whose existence justifies this DeviceUseStatement.

                                            ShortWhy is used (details)
                                            Control0..*
                                            TypeReference(Condition, Observation, DiagnosticReport, DocumentReference, Media)
                                            Is Modifierfalse
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            62. 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
                                            Obligations
                                              ObligationsActor
                                              SHALL:handleHDRConsumer
                                              MAY:able-to-populateHDRCreator
                                              Summarytrue
                                              Requirements

                                              Knowing where the device is targeted is important for tracking if multiple sites are possible. If more information than just a code is required, use the extension http://hl7.org/fhir/StructureDefinition/bodySite.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              64. 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.

                                              ShortAdditional information about the device usage
                                              Control0..*
                                              TypeAnnotation
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))