HDRAlerts
type: StructureDefinition
node role: treeRoot
id:
  v: HDRAlerts
text:
  status:
    v: extensions
  div: Generated Narrative: StructureDefinition HDRAlerts Name Flags Card. Type Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> HDRAlerts 0..* Base A.2.2 - Alerts (eHN) #xD; allergy 1..* BackboneElement A.2.2.1 - Allergy and Intolerance #xD; description 0..1 string A.2.2.1.1 - Allergy description #xD; typeOfPropensity 0..1 CodeableConcept A.2.2.1.2 - Type of propensity #xD; manifestation 0..* CodeableConcept A.2.2.1.3 - Allergy manifestation #xD; severity 0..1 CodeableConcept A.2.2.1.4 - Severity #xD; criticality 0..1 CodeableConcept A.2.2.1.5 - Criticality #xD; onsetDate 0..1 BackboneElement A.2.2.1.6 - Onset date #xD; date 0..1 dateTime Onset date #xD; code 0..1 CodeableConcept Onset date #xD; endDate 0..1 dateTime A.2.2.1.7 - End date #xD; date 0..1 dateTime End date #xD; code 0..1 CodeableConcept End date #xD; status 0..1 CodeableConcept A.2.2.1.8 - Status #xD; certainty 0..1 CodeableConcept A.2.2.1.9 - Certainty #xD; agent 1..1 CodeableConcept A.2.2.1.10 - Agent or Allergen #xD; medicalAlerts 0..* BackboneElement A.2.2.2 - Medical alerts (relevant for the respective hospital stay) #xD; <a href="StructureDefinition-HDRAlerts-definitions.html#HDRAlerts.medicalAlerts.description" title="A warning, other than included in allergies.#xA;The warning can be entered in code (there are codes for frequently used alerts) but seeing the dynamic nature of the warnings, these alerts will often be entered as free text.#xA;Any clinical information that is imperative to know so that the life or health of the patient does not come under threat.#xA;Example 1: the patient has a rare disease that requires special treatment#xA;Example 2: Airway Alert / Difficult Intubation#xA;Example 3: Diagnoses such as malignant hyperthermia, porphyria, and bleeding disorders; special treatments like anticoagulants or immunosuppressants; implanted devices.#xA;Example 4: transplanted organs illustrate other information that has to be taken into account in a healt…
url:
  v: http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/HDRAlerts
version:
  v: 0.1.0
name:
  v: HdrEHNAlerts
title:
  v: A.2.2 - Alerts (eHN)
status:
  v: draft
date:
  v: 2025-10-10T16:32:47+00:00
publisher:
  v: XpanDH Project
contact:
  name:
    v: XpanDH Project
  telecom:
    system:
      v: url
    value:
      v: https://xpandh-project.iscte-iul.pt
description:
  v: Hospital Discharge Report - Alerts - A.2.2 eHN Maturity Level: 0 Draft
jurisdiction:
  coding:
    system:
      v: http://unstats.un.org/unsd/methods/m49/m49.htm
    code:
      v: 150
    display:
      v: Europe
copyright:
  v: Used by permission of the XpanDH project, all rights reserved Creative Commons License
fhir version:
  v: 4.0.1
kind:
  v: logical
abstract:
  v: false
type:
  v: http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/HDRAlerts
base definition:
  v: http://hl7.org/fhir/StructureDefinition/Base
  link: http://hl7.org/fhir/StructureDefinition/Base
derivation:
  v: specialization
snapshot:
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version
    value: string
      v: 4.0.1
  element:
    id:
      v: HDRAlerts
    path:
      v: HDRAlerts
    short:
      v: A.2.2 - Alerts (eHN)
    definition:
      v: Hospital Discharge Report - Alerts - A.2.2 eHN Maturity Level: 0 Draft
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      v: 0
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    base:
      path:
        v: Base
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    is modifier:
      v: false
  element:
    id:
      v: HDRAlerts.allergy
    path:
      v: HDRAlerts.allergy
    short:
      v: A.2.2.1 - Allergy and Intolerance
    definition:
      v: A record of allergies and intolerances (primarily to be used for new allergies or intolerances that occurred during the hospital stay).
    min:
      v: 1
    max:
      v: *
    base:
      path:
        v: HDRAlerts.allergy
      min:
        v: 1
      max:
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    type:
      code:
        v: BackboneElement
    constraint:
      key:
        v: ele-1
      severity:
        v: error
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        v: All FHIR elements must have a @value or children
      expression:
        v: hasValue() or (children().count() > id.count())
      xpath:
        v: @value|f:*|h:div
      source:
        v: http://hl7.org/fhir/StructureDefinition/Element
        link: http://hl7.org/fhir/StructureDefinition/Element
  element:
    id:
      v: HDRAlerts.allergy.id
    path:
      v: HDRAlerts.allergy.id
    representation:
      v: xmlAttr
    short:
      v: Unique id for inter-element referencing
    definition:
      v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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      extension:
        value: url
      code:
        v: http://hl7.org/fhirpath/System.String
    is modifier:
      v: false
    is summary:
      v: false
    mapping:
      identity:
        v: rim
      map:
        v: n/a
  element:
    id:
      v: HDRAlerts.allergy.extension
    path:
      v: HDRAlerts.allergy.extension
    slicing:
      description:
        v: Extensions are always sliced by (at least) url
      rules:
        v: open
    short:
      v: Additional content defined by implementations
    definition:
      v: 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.
    comment:
      v: 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.
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      v: extensions
    alias:
      v: user content
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      v: 0
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    type:
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    constraint:
      key:
        v: ele-1
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      human:
        v: All FHIR elements must have a @value or children
      expression:
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      source:
        v: http://hl7.org/fhir/StructureDefinition/Element
        link: http://hl7.org/fhir/StructureDefinition/Element

url
v: string

v: value

v: url

key:
  v: ext-1
severity:
  v: error
human:
  v: Must have either extensions or value[x], not both
expression:
  v: extension.exists() != value.exists()
xpath:
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source:
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  link: http://hl7.org/fhir/StructureDefinition/Extension

v: false

v: false

identity:
  v: rim
map:
  v: n/a

id:
  v: HDRAlerts.allergy.modifierExtension
path:
  v: HDRAlerts.allergy.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: 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.
requirements:
  v: 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).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
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    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
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    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
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  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
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    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: HDRAlerts.allergy.description
path:
  v: HDRAlerts.allergy.description
short:
  v: A.2.2.1.1 - Allergy description
definition:
  v: Textual description of the allergy or intolerance
min:
  v: 0
max:
  v: 1
base:
  path:
    v: HDRAlerts.allergy.description
  min:
    v: 0
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type:
  code:
    v: string

id:
  v: HDRAlerts.allergy.typeOfPropensity
path:
  v: HDRAlerts.allergy.typeOfPropensity
short:
  v: A.2.2.1.2 - Type of propensity
definition:
  v: This element describes whether this condition refers to an allergy, non-allergy intolerance, or unknown class of intolerance (not known to be allergy or intolerance)
comment:
  v: SNOMED CT
min:
  v: 0
max:
  v: 1
base:
  path:
    v: HDRAlerts.allergy.typeOfPropensity
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    v: 0
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type:
  code:
    v: CodeableConcept

id:
  v: HDRAlerts.allergy.manifestation
path:
  v: HDRAlerts.allergy.manifestation
short:
  v: A.2.2.1.3 - Allergy manifestation
definition:
  v: Description of the clinical manifestation of the allergic reaction including date of manifestation and severity. Example: anaphylactic shock, angioedema (the clinical manifestation also gives information about the severity of the observed reaction). Multiple manifestations could be provided.
comment:
  v: SNOMED CT
min:
  v: 0
max:
  v: *
base:
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type:
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id:
  v: HDRAlerts.allergy.severity
path:
  v: HDRAlerts.allergy.severity
short:
  v: A.2.2.1.4 - Severity
definition:
  v: Severity of the clinical manifestation of the allergic reaction.
comment:
  v: SNOMED CT
min:
  v: 0
max:
  v: 1
base:
  path:
    v: HDRAlerts.allergy.severity
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    v: 0
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    v: 1
type:
  code:
    v: CodeableConcept

id:
  v: HDRAlerts.allergy.criticality
path:
  v: HDRAlerts.allergy.criticality
short:
  v: A.2.2.1.5 - Criticality
definition:
  v: Potential risk for future life-threatening adverse reactions when exposed to a substance known to cause an adverse reaction.
comment:
  v: SNOMED CT
min:
  v: 0
max:
  v: 1
base:
  path:
    v: HDRAlerts.allergy.criticality
  min:
    v: 0
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    v: 1
type:
  code:
    v: CodeableConcept

id:
  v: HDRAlerts.allergy.onsetDate
path:
  v: HDRAlerts.allergy.onsetDate
short:
  v: A.2.2.1.6 - Onset date
definition:
  v: Date of onset of allergy, e.g., date of the first observation of the reaction. Could be also expressed using a date, partial date or life period (childhood, adolescence).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: HDRAlerts.allergy.onsetDate
  min:
    v: 0
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    v: 1
type:
  code:
    v: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element

id:
  v: HDRAlerts.allergy.onsetDate.id
path:
  v: HDRAlerts.allergy.onsetDate.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
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type:
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    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value: url
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: HDRAlerts.allergy.onsetDate.extension
path:
  v: HDRAlerts.allergy.onsetDate.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Additional content defined by implementations
definition:
  v: 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.
comment:
  v: 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.
alias:
  v: extensions
alias:
  v: user content
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constraint:
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    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
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  v: false
mapping:
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id:
  v: HDRAlerts.allergy.onsetDate.modifierExtension
path:
  v: HDRAlerts.allergy.onsetDate.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: 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.
requirements:
  v: 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).
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alias:
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alias:
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max:
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is summary:
  v: true
mapping:
  identity:
    v: rim
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    v: N/A

id:
  v: HDRAlerts.allergy.onsetDate.date
path:
  v: HDRAlerts.allergy.onsetDate.date
short:
  v: Onset date
definition:
  v: Date of onset of allergy, e.g., date of the first observation of the reaction. Could be also expressed using a date or partial date.
min:
  v: 0
max:
  v: 1
base:
  path:
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    v: 0
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type:
  code:
    v: dateTime

id:
  v: HDRAlerts.allergy.onsetDate.code
path:
  v: HDRAlerts.allergy.onsetDate.code
short:
  v: Onset date
definition:
  v: Date of onset of allergy, e.g., date of the first observation of the reaction expressed using code for life period (childhood, adolescence).
comment:
  v: SNOMED CT
min:
  v: 0
max:
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base:
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    v: HDRAlerts.allergy.onsetDate.code
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type:
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id:
  v: HDRAlerts.allergy.endDate
path:
  v: HDRAlerts.allergy.endDate
short:
  v: A.2.2.1.7 - End date
definition:
  v: Date of resolution of the allergy (e.g. when the clinician deemed there is no longer any need to track the underlying condition)
min:
  v: 0
max:
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base:
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constraint:
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id:
  v: HDRAlerts.allergy.endDate.id
path:
  v: HDRAlerts.allergy.endDate.id
representation:
  v: xmlAttr
short:
  v: xml:id (or equivalent in JSON)
definition:
  v: unique id for the element within a resource (for internal references)
min:
  v: 0
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  v: 1
base:
  path:
    v: Element.id
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type:
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    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value: url
      v: string
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    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false

id:
  v: HDRAlerts.allergy.endDate.extension
path:
  v: HDRAlerts.allergy.endDate.extension
short:
  v: Additional content defined by implementations
definition:
  v: 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.
comment:
  v: 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.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
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constraint:
  key:
    v: ele-1
  severity:
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    v: hasValue() or (children().count() > id.count())
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constraint:
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  severity:
    v: error
  human:
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    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: HDRAlerts.allergy.endDate.value
path:
  v: HDRAlerts.allergy.endDate.value
representation:
  v: xmlAttr
short:
  v: Primitive value for dateTime
definition:
  v: The actual value
min:
  v: 0
max:
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base:
  path:
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  min:
    v: 0
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type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value: url
      v: dateTime
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/regex
    value: string
      v: ([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)(-(0[1-9]|1[0-2])(-(0[1-9]|[1-2][0-9]|3[0-1])(T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\.[0-9]+)?(Z|(\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00)))?)?)?
  code:
    v: http://hl7.org/fhirpath/System.DateTime
is modifier:
  v: false
is summary:
  v: false

id:
  v: HDRAlerts.allergy.endDate.date
path:
  v: HDRAlerts.allergy.endDate.date
short:
  v: End date
definition:
  v: Date of resolution of the allergy (e.g. when the clinician deemed there is no longer any need to track the underlying condition)
min:
  v: 0
max:
  v: 1
base:
  path:
    v: HDRAlerts.allergy.endDate.date
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: dateTime

id:
  v: HDRAlerts.allergy.endDate.code
path:
  v: HDRAlerts.allergy.endDate.code
short:
  v: End date
definition:
  v: Date of resolution of the allergy expressed by code (e.g. age group)
comment:
  v: SNOMED CT
min:
  v: 0
max:
  v: 1
base:
  path:
    v: HDRAlerts.allergy.endDate.code
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept

id:
  v: HDRAlerts.allergy.status
path:
  v: HDRAlerts.allergy.status
short:
  v: A.2.2.1.8 - Status
definition:
  v: Current status of the allergy or intolerance, for example, whether it is active, in remission, resolved, and so on …
comment:
  v: Active, resolved, …
min:
  v: 0
max:
  v: 1
base:
  path:
    v: HDRAlerts.allergy.status
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept

id:
  v: HDRAlerts.allergy.certainty
path:
  v: HDRAlerts.allergy.certainty
short:
  v: A.2.2.1.9 - Certainty
definition:
  v: Assertion about the certainty associated with a propensity, or potential risk, of a reaction to the identified substance. Diagnostic and/or clinical evidence of condition.
comment:
  v: SNOMED CT
min:
  v: 0
max:
  v: 1
base:
  path:
    v: HDRAlerts.allergy.certainty
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept

id:
  v: HDRAlerts.allergy.agent
path:
  v: HDRAlerts.allergy.agent
short:
  v: A.2.2.1.10 - Agent or Allergen
definition:
  v: A specific allergen or other agent/substance (drug, food, chemical agent, etc.) to which the patient has an adverse reaction propensity.
comment:
  v: SNOMED CT ATC (IDMP / EMA SPOR SMS)
min:
  v: 1
max:
  v: 1
base:
  path:
    v: HDRAlerts.allergy.agent
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: CodeableConcept

id:
  v: HDRAlerts.medicalAlerts
path:
  v: HDRAlerts.medicalAlerts
short:
  v: A.2.2.2 - Medical alerts (relevant for the respective hospital stay)
definition:
  v: Medical alerts (relevant for the respective hospital stay)
min:
  v: 0
max:
  v: *
base:
  path:
    v: HDRAlerts.medicalAlerts
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element

id:
  v: HDRAlerts.medicalAlerts.id
path:
  v: HDRAlerts.medicalAlerts.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value: url
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: HDRAlerts.medicalAlerts.extension
path:
  v: HDRAlerts.medicalAlerts.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Additional content defined by implementations
definition:
  v: 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.
comment:
  v: 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.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: HDRAlerts.medicalAlerts.modifierExtension
path:
  v: HDRAlerts.medicalAlerts.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: 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.
requirements:
  v: 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).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: HDRAlerts.medicalAlerts.description
path:
  v: HDRAlerts.medicalAlerts.description
short:
  v: A.2.2.2.1 - Healthcare alert description
definition:
  v: A warning, other than included in allergies. The warning can be entered in code (there are codes for frequently used alerts) but seeing the dynamic nature of the warnings, these alerts will often be entered as free text. Any clinical information that is imperative to know so that the life or health of the patient does not come under threat. Example 1: the patient has a rare disease that requires special treatment Example 2: Airway Alert / Difficult Intubation Example 3: Diagnoses such as malignant hyperthermia, porphyria, and bleeding disorders; special treatments like anticoagulants or immunosuppressants; implanted devices. Example 4: transplanted organs illustrate other information that has to be taken into account in a healthcare contact. Example 5: participation in a clinical trial that has to be taken into account in a healthcare contact.
comment:
  v: SNOMED CT LOINC
min:
  v: 0
max:
  v: 1
base:
  path:
    v: HDRAlerts.medicalAlerts.description
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept

element:
  id:
    v: HDRAlerts
  path:
    v: HDRAlerts
  short:
    v: A.2.2 - Alerts (eHN)
  definition:
    v: Hospital Discharge Report - Alerts - A.2.2 eHN Maturity Level: 0 Draft
element:
  id:
    v: HDRAlerts.allergy
  path:
    v: HDRAlerts.allergy
  short:
    v: A.2.2.1 - Allergy and Intolerance
  definition:
    v: A record of allergies and intolerances (primarily to be used for new allergies or intolerances that occurred during the hospital stay).
  min:
    v: 1
  max:
    v: *
  type:
    code:
      v: BackboneElement
element:
  id:
    v: HDRAlerts.allergy.description
  path:
    v: HDRAlerts.allergy.description
  short:
    v: A.2.2.1.1 - Allergy description
  definition:
    v: Textual description of the allergy or intolerance
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: string
element:
  id:
    v: HDRAlerts.allergy.typeOfPropensity
  path:
    v: HDRAlerts.allergy.typeOfPropensity
  short:
    v: A.2.2.1.2 - Type of propensity
  definition:
    v: This element describes whether this condition refers to an allergy, non-allergy intolerance, or unknown class of intolerance (not known to be allergy or intolerance)
  comment:
    v: SNOMED CT
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: CodeableConcept
element:
  id:
    v: HDRAlerts.allergy.manifestation
  path:
    v: HDRAlerts.allergy.manifestation
  short:
    v: A.2.2.1.3 - Allergy manifestation
  definition:
    v: Description of the clinical manifestation of the allergic reaction including date of manifestation and severity. Example: anaphylactic shock, angioedema (the clinical manifestation also gives information about the severity of the observed reaction). Multiple manifestations could be provided.
  comment:
    v: SNOMED CT
  min:
    v: 0
  max:
    v: *
  type:
    code:
      v: CodeableConcept
element:
  id:
    v: HDRAlerts.allergy.severity
  path:
    v: HDRAlerts.allergy.severity
  short:
    v: A.2.2.1.4 - Severity
  definition:
    v: Severity of the clinical manifestation of the allergic reaction.
  comment:
    v: SNOMED CT
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: CodeableConcept
element:
  id:
    v: HDRAlerts.allergy.criticality
  path:
    v: HDRAlerts.allergy.criticality
  short:
    v: A.2.2.1.5 - Criticality
  definition:
    v: Potential risk for future life-threatening adverse reactions when exposed to a substance known to cause an adverse reaction.
  comment:
    v: SNOMED CT
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: CodeableConcept
element:
  id:
    v: HDRAlerts.allergy.onsetDate
  path:
    v: HDRAlerts.allergy.onsetDate
  short:
    v: A.2.2.1.6 - Onset date
  definition:
    v: Date of onset of allergy, e.g., date of the first observation of the reaction. Could be also expressed using a date, partial date or life period (childhood, adolescence).
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: BackboneElement
element:
  id:
    v: HDRAlerts.allergy.onsetDate.date
  path:
    v: HDRAlerts.allergy.onsetDate.date
  short:
    v: Onset date
  definition:
    v: Date of onset of allergy, e.g., date of the first observation of the reaction. Could be also expressed using a date or partial date.
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: dateTime
element:
  id:
    v: HDRAlerts.allergy.onsetDate.code
  path:
    v: HDRAlerts.allergy.onsetDate.code
  short:
    v: Onset date
  definition:
    v: Date of onset of allergy, e.g., date of the first observation of the reaction expressed using code for life period (childhood, adolescence).
  comment:
    v: SNOMED CT
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: CodeableConcept
element:
  id:
    v: HDRAlerts.allergy.endDate
  path:
    v: HDRAlerts.allergy.endDate
  short:
    v: A.2.2.1.7 - End date
  definition:
    v: Date of resolution of the allergy (e.g. when the clinician deemed there is no longer any need to track the underlying condition)
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: dateTime
element:
  id:
    v: HDRAlerts.allergy.endDate.date
  path:
    v: HDRAlerts.allergy.endDate.date
  short:
    v: End date
  definition:
    v: Date of resolution of the allergy (e.g. when the clinician deemed there is no longer any need to track the underlying condition)
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: dateTime
element:
  id:
    v: HDRAlerts.allergy.endDate.code
  path:
    v: HDRAlerts.allergy.endDate.code
  short:
    v: End date

v: Date of resolution of the allergy expressed by code (e.g. age group)

v: SNOMED CT

v: 0

v: 1

code:
  v: CodeableConcept

id:
  v: HDRAlerts.allergy.status
path:
  v: HDRAlerts.allergy.status
short:
  v: A.2.2.1.8 - Status
definition:
  v: Current status of the allergy or intolerance, for example, whether it is active, in remission, resolved, and so on …
comment:
  v: Active, resolved, …
min:
  v: 0
max:
  v: 1
type:
  code:
    v: CodeableConcept

id:
  v: HDRAlerts.allergy.certainty
path:
  v: HDRAlerts.allergy.certainty
short:
  v: A.2.2.1.9 - Certainty
definition:
  v: Assertion about the certainty associated with a propensity, or potential risk, of a reaction to the identified substance. Diagnostic and/or clinical evidence of condition.
comment:
  v: SNOMED CT
min:
  v: 0
max:
  v: 1
type:
  code:
    v: CodeableConcept

id:
  v: HDRAlerts.allergy.agent
path:
  v: HDRAlerts.allergy.agent
short:
  v: A.2.2.1.10 - Agent or Allergen
definition:
  v: A specific allergen or other agent/substance (drug, food, chemical agent, etc.) to which the patient has an adverse reaction propensity.
comment:
  v: SNOMED CT ATC (IDMP / EMA SPOR SMS)
min:
  v: 1
max:
  v: 1
type:
  code:
    v: CodeableConcept

id:
  v: HDRAlerts.medicalAlerts
path:
  v: HDRAlerts.medicalAlerts
short:
  v: A.2.2.2 - Medical alerts (relevant for the respective hospital stay)
definition:
  v: Medical alerts (relevant for the respective hospital stay)
min:
  v: 0
max:
  v: *
type:
  code:
    v: BackboneElement

id:
  v: HDRAlerts.medicalAlerts.description
path:
  v: HDRAlerts.medicalAlerts.description
short:
  v: A.2.2.2.1 - Healthcare alert description
definition:
  v: A warning, other than included in allergies. The warning can be entered in code (there are codes for frequently used alerts) but seeing the dynamic nature of the warnings, these alerts will often be entered as free text. Any clinical information that is imperative to know so that the life or health of the patient does not come under threat. Example 1: the patient has a rare disease that requires special treatment Example 2: Airway Alert / Difficult Intubation Example 3: Diagnoses such as malignant hyperthermia, porphyria, and bleeding disorders; special treatments like anticoagulants or immunosuppressants; implanted devices. Example 4: transplanted organs illustrate other information that has to be taken into account in a healthcare contact. Example 5: participation in a clinical trial that has to be taken into account in a healthcare contact.
comment:
  v: SNOMED CT LOINC
min:
  v: 0
max:
  v: 1
type:
  code:
    v: CodeableConcept