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-RiskAssessment-1 - Detailed Descriptions

Definitions for the CareConnect-RiskAssessment-1 Profile.

1. RiskAssessment
Definition

An assessment of the likely outcome(s) for a patient or other subject as well as the likelihood of each outcome.

Control0..*
Alternate NamesPrognosis
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())
2. RiskAssessment.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. RiskAssessment.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. RiskAssessment.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. RiskAssessment.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. RiskAssessment.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. RiskAssessment.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. RiskAssessment.extension
Definition

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

9. RiskAssessment.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.

10. RiskAssessment.identifier
Definition

Business identifier assigned to the risk assessment.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
TypeIdentifier
11. RiskAssessment.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
12. RiskAssessment.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 RiskAssessment.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
13. RiskAssessment.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.

14. RiskAssessment.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.

15. RiskAssessment.identifier.system
Definition

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

Control0..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
16. RiskAssessment.identifier.value
Definition

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

Control0..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
17. RiskAssessment.identifier.period
Definition

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

Control0..1
TypePeriod
18. RiskAssessment.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.

19. RiskAssessment.basedOn
Definition

A reference to the request that is fulfilled by this risk assessment.

Control0..1
TypeReference(Resource)
20. RiskAssessment.parent
Definition

A reference to a resource that this risk assessment is part of, such as a Procedure.

Control0..1
TypeReference(Resource)
21. RiskAssessment.status
Definition

The status of the RiskAssessment, using the same statuses as an Observation.

Control1..1
BindingThe status of the risk assessment; e.g. preliminary, final, amended, etc.
The codes SHALL be taken from ObservationStatus
Typecode
22. RiskAssessment.method
Definition

The algorithm, process or mechanism used to evaluate the risk.

Control0..1
BindingThe mechanism or algorithm used to make the assessment; e.g. TIMI, PRISM, Cardiff Type 2 diabetes, etc.
TypeCodeableConcept
Requirements

The method can influence the results of the assessment.

23. RiskAssessment.code
Definition

The type of the risk assessment performed.

Control0..1
TypeCodeableConcept
24. RiskAssessment.subject
Definition

The patient or group the risk assessment applies to.

Control0..1
TypeReference(Group | CareConnect-Patient-1)
25. RiskAssessment.context
Definition

The encounter where the assessment was performed.

Control0..1
TypeReference(CareConnect-EpisodeOfCare-1 | CareConnect-Encounter-1)
26. RiskAssessment.occurrence[x]
Definition

The date (and possibly time) the risk assessment was performed.

Control0..1
TypeChoice of: dateTime, Period
[x] NoteSee Choice of Data Types for further information about how to use [x]
Requirements

The assessment results lose validity the more time elapses from when they are first made.

27. RiskAssessment.condition
Definition

For assessments or prognosis specific to a particular condition, indicates the condition being assessed.

Control0..1
TypeReference(CareConnect-Condition-1)
28. RiskAssessment.performer
Definition

The provider or software application that performed the assessment.

Control0..1
TypeReference(Device | CareConnect-Practitioner-1)
29. RiskAssessment.reason[x]
Definition

The reason the risk assessment was performed.

Control0..1
TypeChoice of: CodeableConcept, Reference(Resource)
[x] NoteSee Choice of Data Types for further information about how to use [x]
30. RiskAssessment.basis
Definition

Indicates the source data considered as part of the assessment (FamilyHistory, Observations, Procedures, Conditions, etc.).

Control0..*
TypeReference(Resource)
31. RiskAssessment.prediction
Definition

Describes the expected outcome for the subject.

Control0..*
TypeBackboneElement
Comments

Multiple repetitions can be used to identify the same type of outcome in different timeframes as well as different types of outcomes.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
ras-2: Must be <= 100 (: probability is decimal implies probability.as(decimal) <= 100)
32. RiskAssessment.prediction.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
33. RiskAssessment.prediction.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.

34. RiskAssessment.prediction.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.

35. RiskAssessment.prediction.outcome
Definition

One of the potential outcomes for the patient (e.g. remission, death, a particular condition).

Control1..1
BindingThe condition or other outcome; e.g. death, remission, amputation, infection, etc.
TypeCodeableConcept
36. RiskAssessment.prediction.probability[x]
Definition

How likely is the outcome (in the specified timeframe).

Control0..1
TypeChoice of: decimal, Range
[x] NoteSee Choice of Data Types for further information about how to use [x]
Comments

If range is used, it represents the lower and upper bounds of certainty; e.g. 40-60% Decimal values are expressed as percentages as well (max = 100).

InvariantsDefined on this element
ras-1: low and high must be percentages, if present (: (low.empty() or ((low.code = '%') and (low.system = %ucum))) and (high.empty() or ((high.code = '%') and (high.system = %ucum))))
37. RiskAssessment.prediction.qualitativeRisk
Definition

How likely is the outcome (in the specified timeframe), expressed as a qualitative value (e.g. low, medium, high).

Control0..1
BindingThe likelihood of the occurrence of a specified outcome
For example codes, see Risk Probability
TypeCodeableConcept
38. RiskAssessment.prediction.relativeRisk
Definition

Indicates the risk for this particular subject (with their specific characteristics) divided by the risk of the population in general. (Numbers greater than 1 = higher risk than the population, numbers less than 1 = lower risk.).

Control0..1
Typedecimal
Requirements

Absolute risk is less meaningful than relative risk.

39. RiskAssessment.prediction.when[x]
Definition

Indicates the period of time or age range of the subject to which the specified probability applies.

Control0..1
TypeChoice of: Period, Range
[x] NoteSee Choice of Data Types for further information about how to use [x]
Comments

If not specified, the risk applies "over the subject's lifespan".

40. RiskAssessment.prediction.rationale
Definition

Additional information explaining the basis for the prediction.

Control0..1
Typestring
41. RiskAssessment.mitigation
Definition

A description of the steps that might be taken to reduce the identified risk(s).

Control0..1
Typestring
Requirements

One of the main reasons for assessing risks is to identify whether interventional steps are needed to reduce risk.

42. RiskAssessment.comment
Definition

Additional comments about the risk assessment.

Control0..1
Typestring