INTEROPen CareConnect Base STU3 Implementation Guide
3.0.0 - CI Build

INTEROPen CareConnect Base STU3 Implementation Guide - Local Development build (v3.0.0). See the Directory of published versions

StructureDefinition: CareConnect-List-1 - Detailed Descriptions

Definitions for the CareConnect-List-1 Profile.

1. List
Definition

A set of information summarized from a list of other resources.

Control0..*
Alternate NamesCollection, WorkingList, Organizer
InvariantsDefined on this element
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (: contained.text.empty())
dom-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 (: contained.where(('#'+id in %resource.descendants().reference).not()).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())
lst-1: A list can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty())
lst-2: The deleted flag can only be used if the mode of the list is "changes" (: mode = 'changes' or entry.deleted.empty())
2. List.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Control0..1
Typeid
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.

3. List.meta
Definition

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

Control0..1
TypeMeta
4. List.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.

Control0..1
Typeuri
Is Modifiertrue
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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

5. List.language
Definition

The base language in which the resource is written.

Control0..1
BindingA human language.
The codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable
Max Binding: All Languages
Typecode
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).

6. List.text
Definition

A human-readable narrative that contains a summary of the resource, and may 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.

Control0..1 This element is affected by the following invariants: dom-1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
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 in formation is added later.

7. List.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.

Control0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained 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.

8. List.extension
Definition

An Extension

Control0..*
TypeExtension
SlicingThis element introduces a set of slices on List.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
9. List.extension:clinicalSetting
SliceNameclinicalSetting
Definition

To record the clinical setting of a problem list.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(Extension-CareConnect-ClinicalSetting-1) (Extension Type: CodeableConcept)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
10. List.extension:warningCode
SliceNamewarningCode
Definition

To capture warnings that the list may be incomplete.

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(Extension-CareConnect-ListWarningCode-1) (Extension Type: code)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
11. List.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. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content
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.

12. List.identifier
Definition

Identifier for the List assigned for business purposes outside the context of FHIR.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
13. List.identifier.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
14. List.identifier.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

SlicingThis element introduces a set of slices on List.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
15. List.identifier.use
Definition

The purpose of this identifier.

Control0..1
BindingIdentifies the purpose for this identifier, if known .
The codes SHALL be taken from IdentifierUse
Typecode
Is Modifiertrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

16. List.identifier.type
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Control0..1
BindingA coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
The codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable
TypeCodeableConcept
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

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.

17. List.identifier.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Control1..1
Typeuri
Requirements

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.

Example
General:http://www.acme.com/identifiers/patient
18. List.identifier.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Control1..1
Typestring
Comments

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.

Example
General:123456
19. List.identifier.period
Definition

Time period during which identifier is/was valid for use.

Control0..1
TypePeriod
20. List.identifier.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(CareConnect-Organization-1)
Comments

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.

21. List.status
Definition

Indicates the current state of this list.

Control1..1
BindingThe current state of the list
The codes SHALL be taken from ListStatus
Typecode
Is Modifiertrue
Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

22. List.mode
Definition

How this list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Control1..1
BindingThe processing mode that applies to this list
The codes SHALL be taken from ListMode
Typecode
Is Modifiertrue
Requirements

Lists are used in various ways, and it must be known in what way it is safe to use them.

Comments

This element is labeled as a modifier because a change list must not be mis-understood as a complete list.

23. List.title
Definition

A label for the list assigned by the author.

Control0..1
Typestring
Requirements

Allows customization beyond just the code identifying the kind of list.

Example
General:Dr. Jane's Patients
24. List.code
Definition

This code defines the purpose of the list - why it was created.

Control0..1
BindingThe codes SHOULD be taken from Care Connect List Code
TypeCodeableConcept
Requirements

Lists often contain subsets of resources rather than an exhaustive list. The code identifies what type of subset is included.

Comments

If there is no code, the purpose of the list is implied where it is used, such as in a document section using Document.section.code.

25. List.subject
Definition

The common subject (or patient) of the resources that are in the list, if there is one.

Control0..1
TypeReference(Group | Device | CareConnect-Patient-1 | CareConnect-Location-1)
Requirements

The primary purpose of listing the subject explicitly is to help with finding the right list.

Comments

Some purely arbitrary lists do not have a common subject, so this is optional.

26. List.encounter
Definition

The encounter that is the context in which this list was created.

Control0..1
TypeReference(CareConnect-Encounter-1)
27. List.date
Definition

The date that the list was prepared.

Control0..1
TypedateTime
Requirements

Identifies how current the list is which affects relevance.

Comments

The actual important date is the date of currency of the resources that were summarized, but it is usually assumed that these are current when the preparation occurs.

28. List.source
Definition

The entity responsible for deciding what the contents of the list were. Where the list was created by a human, this is the same as the author of the list.

Control0..1
TypeReference(Device | CareConnect-Patient-1 | CareConnect-Practitioner-1)
Requirements

Allows follow-up as well as context.

Alternate NamesAuthor
Comments

The primary source is the entity that made the decisions what items are in the list. This may be software or user.

29. List.orderedBy
Definition

What order applies to the items in the list.

Control0..1
BindingWhat order applies to the items in a list
The codes SHOULD be taken from List Order Codes
TypeCodeableConcept
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

30. List.note
Definition

Comments that apply to the overall list.

Control0..*
TypeAnnotation
31. List.note.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
32. List.note.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

SlicingThis element introduces a set of slices on List.note.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
33. List.note.author[x]
Definition

The individual responsible for making the annotation.

Control0..1
TypeChoice of: Reference(RelatedPerson | CareConnect-Patient-1 | CareConnect-Practitioner-1), string
[x] NoteSee Choice of Data Types for further information about how to use [x]
34. List.note.time
Definition

Indicates when this particular annotation was made.

Control0..1
TypedateTime
35. List.note.text
Definition

The text of the annotation.

Control1..1
Typestring
36. List.entry
Definition

Entries in this list.

Control0..* This element is affected by the following invariants: lst-1
TypeBackboneElement
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
37. List.entry.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
38. List.entry.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

39. List.entry.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
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.

40. List.entry.flag
Definition

The flag allows the system constructing the list to indicate the role and significance of the item in the list.

Control0..1
BindingCodes that provide further information about the reason and meaning of the item in the list
For example codes, see Patient Medicine Change Types
TypeCodeableConcept
Requirements

This field is present to support various clinical uses of lists, such as a discharge summary medication list, where flags specify whether the medication was added, modified, or deleted from the list.

Comments

The flag can only be understood in the context of the List.code. If the flag means that the entry has actually been deleted from the list, the deleted element SHALL be true. Deleted can only be used if the List.mode is "changes".

41. List.entry.deleted
Definition

True if this item is marked as deleted in the list.

Control0..1 This element is affected by the following invariants: lst-2
Typeboolean
Is Modifiertrue
Requirements

The flag element may contain codes that an application processing the list does not understand. However there can be no ambiguity if a list item is actually marked as "deleted".

Comments

If the flag means that the entry has actually been deleted from the list, the deleted element SHALL be true. Both flag and deleted can only be used if the List.mode is "changes". A deleted entry should be displayed in narrative as deleted.

This element is labeled as a modifier because it indicates that an item is (to be) no longer in the list.

Default Valuefalse
42. List.entry.date
Definition

When this item was added to the list.

Control0..1
TypedateTime
Requirements

The date may be significant for understanding the meaning of items in a working list.

Comments

This is only useful and meaningful when the mode is "working".

43. List.entry.item
Definition

A reference to the actual resource from which data was derived.

Control1..1
TypeReference(Resource)
44. List.emptyReason
Definition

If the list is empty, why the list is empty.

Control0..1 This element is affected by the following invariants: lst-1
BindingThe codes SHOULD be taken from Care Connect List Empty Reason Code
TypeCodeableConcept
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty list make a significant interpretation to its interpretation. Note that this code is for use when the entire list has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.