Generated Narrative: StructureDefinition immunosuppressive-maintenance-patient Name Flags Card. Type Description & Constraints Basic 0..* Basic Resource for non-supported content #xD; Slices for extension 3..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:patient_id S 1..1 Reference(Transplant Recipient) patient_id – reference to PatientTransplant URL: https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/immunosuppressive-maintenance-patient-ref #xD; extension:immunosuppressant_id S 1..1 Reference(Immunosuppressant) immunosuppressant_id – reference to Immunosuppressant URL: https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/immunosuppressive-maintenance-immunosuppressant-ref #xD; extension:dose S 1..1 Quantity dose – maintenance dose of the immunosuppressant URL: https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/immunosuppressive-maintenance-dose #xD; extension:pre_dose_level S 0..1 Quantity pre_dose_level – drug level before dosing (trough) URL: https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/immunosuppressive-maintenance-pre-dose-level #xD; extension:csa2h_post_dose_level S 0..1 Quantity csa2h_post_dose_level – drug level 2 hours after dosing (C2) URL: https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/immunosuppressive-maintenance-csa2h-post-dose-level #xD; extension:auc S 0..1 Quantity auc – area under the concentration–time curve URL: https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/immunosuppressive-maintenance-auc #xD; extension:start_date S 0..1 date start_date – date maintenance therapy started URL: https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/immunosuppressive-maintenance-start-date #xD; extension:end_date S 0..1 date end_date – date maintenance therapy stopped URL: https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/immunosuppressive-maintenance-end-date #xD; identifier S 1..1 Identifier imm_main_pat_id – identifier of the immunosuppressive maintenance record #xD; system 1..1 uri The namespace for the identifier value Fixed Value: https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/NamingSystem/immunosuppressive-maintenance-patient-id #xD; value 1..1 string The value that is unique #xD; code S 1..1 CodeableConcept Type of immunosuppressive maintenance record Binding: Immunosuppressive Maintenance to Patient Type ValueSet (required): Codes for identifying types of resources not yet defined by FHIR. #xD; Documentation for this format
Immunosuppressive Maintenance to Patient
Maintenance immunosuppressive therapy given to the transplant patient, aligned with the immunosuppressive_maintenance_patient table.
Basic is used for handling concepts not yet defined in FHIR, narrative-only resources that don't map to an existing resource, and custom resources not appropriate for inclusion in the FHIR specification.
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
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()
not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
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()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If a resource is contained in another resource, it SHALL NOT have a security label
When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
A resource should have narrative for robust management
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
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.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
A set of rules under which this content was created
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.
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.
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
The base language in which the resource is written.
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).
Text summary of the resource, for human interpretation
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.
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.
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.
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.
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
patient_id – reference to PatientTransplant
patient_id – reference to the transplant recipient for whom maintenance therapy is recorded.
exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
immunosuppressant_id – reference to Immunosuppressant
immunosuppressant_id – reference to the immunosuppressant drug used for maintenance.
dose – maintenance dose of the immunosuppressant
dose – maintenance dose of the immunosuppressant.
pre_dose_level – drug level before dosing (trough)
pre_dose_level – drug level measured immediately before dosing (trough level).
csa2h_post_dose_level – drug level 2 hours after dosing (C2)
csa2h_post_dose_level – drug level measured 2 hours after dosing (commonly cyclosporine C2).
auc – area under the concentration–time curve
auc – pharmacokinetic area under the curve for the immunosuppressant.
start_date – date maintenance therapy started
Date when this maintenance immunosuppressant regimen was started.
end_date – date maintenance therapy stopped
Date when this maintenance immunosuppressant regimen was stopped (if applicable).
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).
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.
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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
imm_main_pat_id – identifier of the immunosuppressive maintenance record
Identifier assigned to the resource for business purposes, outside the context of FHIR.
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
Additional content defined by implementations
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.
usual | official | temp | secondary | old (If known)
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Identifies the purpose for this identifier, if known .
A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Allows users to make use of identifiers when the identifier system is not known.
A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Identifier.system is always case sensitive.
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
The portion of the identifier typically relevant to the user and which is unique within the context of the system.
If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [Rendered Value extension](http://hl7.org/fhir/R4/extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
Time period when id is/was valid for use
Time period during which identifier is/was valid for use.
Role.effectiveTime or implied by context
Organization that issued id (may be just text)
Organization that issued/manages the identifier.
The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
Type of immunosuppressive maintenance record
Identifies the 'type' of resource - equivalent to the resource name for other resources.
Because resource references will only be able to indicate 'Basic', the type of reference will need to be specified in a Profile identified as part of the resource. Refer to the resource notes section for information on appropriate terminologies for this code. This element is labeled as a modifier because it defines the meaning of the resource and cannot be ignored.
Must be able to distinguish different types of Basic resources.
This element determines what kind of resource is being represented which drives the meaning of all of the other elements.
Codes for identifying types of resources not yet defined by FHIR.
Identifies the patient, practitioner, device or any other resource that is the "focus" of this resource.
Optional as not all potential resources will have subjects. Resources associated with multiple subjects can handle this via extension.
Needed for partitioning the resource by Patient.
./participation[typeCode='SBJ'] (possibly through a ControlAct and Role)
Identifies when the resource was first created.
Allows ordering resource instances by time.
./participation[typeCode='AUT']/time (possibly through a ControlAct and Role)
Indicates who was responsible for creating the resource instance.
./participation[typeCode='SUB'] (possibly through a ControlAct and Role)