Profile: cqf-riskassessment

cqf-riskassessment

Raw XML

<Profile xmlns="http://hl7.org/fhir">
  <id value="cqf-riskassessment-cqf-riskassessment"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><!-- Snipped for brevity --></div>
  </text>
  <url value="http://hl7.org/fhir/Profile/cqf-riskassessment-cqf-riskassessment"/>
  <name value="Clinical Quality Framework (CQF) Risk Assessment Profile"/>
  <publisher value="Health Level Seven, Inc. - CQI WG"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://hl7.org/special/committees/CQI"/>
    </telecom>
  </contact>
  <description value="Profile of Risk Assessment for decision support/quality metrics. Indicates which elements
   must be supported by CQF rules and measure engines. : Clinical Quality Framework (CQF)
   Risk Assessment Profile"/>
  <status value="draft"/>
  <date value="2014-12-05"/>
  <type value="RiskAssessment"/>
  <base value="http://hl7.org/fhir/Profile/RiskAssessment"/>
  <snapshot>
    <element>
      <path value="RiskAssessment"/>
      <name value="cqf-riskassessment"/>
      <short value="Potential outcomes for a subject with likelihood"/>
      <definition value="An assessment of the likely outcome(s) for a patient or other subject as well as the likelihood
       of each outcome."/>
      <synonym value="Prognosis"/>
      <min value="1"/>
      <max value="1"/>
      <mapping>
        <identity value="v2"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Observation[classCode=OBS, moodCode=EVN, code=&quot;Risk Assessment&quot;]"/>
      </mapping>
      <mapping>
        <identity value="openehr"/>
        <map value="OpenEHR-EHR-EVALUATION.risk.v1"/>
      </mapping>
    </element>
    <element>
      <path value="RiskAssessment.id"/>
      <short value="Logical id of this artefact"/>
      <definition value="The logical id of the resource, as used in the url for the resoure. Once assigned, this
       value never changes."/>
      <comments value="The only time that a resource does not have an id is when it is being submitted to the
       server using a create operation. Bundles always have an id, though it is usually a generated
       UUID."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="id"/>
      </type>
    </element>
    <element>
      <path value="RiskAssessment.meta"/>
      <short value="Metadata about the resource"/>
      <definition value="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."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Meta"/>
      </type>
    </element>
    <element>
      <path value="RiskAssessment.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition value="A reference to a set of rules that were followed when the resource was constructed, and
       which must be understood when processing the content."/>
      <comments value="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 as much as possible."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="uri"/>
      </type>
      <isModifier value="true"/>
    </element>
    <element>
      <path value="RiskAssessment.language"/>
      <short value="Language of the resource content"/>
      <definition value="The base language in which the resource is written."/>
      <comments value="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)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <name value="Language"/>
        <isExtensible value="false"/>
        <conformance value="required"/>
        <description value="A human language"/>
        <referenceUri value="http://tools.ietf.org/html/bcp47"/>
      </binding>
    </element>
    <element>
      <path value="RiskAssessment.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition value="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 &quot;clinically
       safe&quot; for a human to just read the narrative. Resource definitions may define what
       content should be represented in the narrative to ensure clinical safety."/>
      <comments value="Contained resources do not have narrative. Resources that are not contained SHOULD have
       a narrative."/>
      <synonym value="narrative"/>
      <synonym value="html"/>
      <synonym value="xhtml"/>
      <synonym value="display"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Narrative"/>
      </type>
      <condition value="dom-1"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element>
      <path value="RiskAssessment.contained"/>
      <short value="Contained, inline Resources"/>
      <definition value="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."/>
      <comments value="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."/>
      <synonym value="inline resources"/>
      <synonym value="anonymous resources"/>
      <synonym value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Resource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="RiskAssessment.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="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."/>
      <comments value="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."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="RiskAssessment.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="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."/>
      <comments value="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."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="RiskAssessment.subject"/>
      <short value="Who/what does assessment apply to?"/>
      <definition value="The patient or group the risk assessment applies to."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/Profile/Patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/Profile/Group"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=SBJ].role"/>
      </mapping>
      <mapping>
        <identity value="openehr"/>
        <map value="Subject of Care"/>
      </mapping>
    </element>
    <element>
      <path value="RiskAssessment.date"/>
      <short value="When was assessment made?"/>
      <definition value="The date (and possibly time) the risk assessment was performed."/>
      <requirements value="The assessment results lose validity the more time elapses from when they are first made."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="dateTime"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime"/>
      </mapping>
    </element>
    <element>
      <path value="RiskAssessment.condition"/>
      <short value="Condition assessed"/>
      <definition value="For assessments or prognosis specific to a particular condition, indicates the condition
       being assessed."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/Profile/Condition"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN]"/>
      </mapping>
    </element>
    <element>
      <path value="RiskAssessment.performer"/>
      <short value="Who did assessment?"/>
      <definition value="The provider or software application that performed the assessment."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/Profile/Practitioner"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/Profile/Device"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PFM].role[classCode=ASSIGNED]"/>
      </mapping>
      <mapping>
        <identity value="openehr"/>
        <map value="Information Provider"/>
      </mapping>
    </element>
    <element>
      <path value="RiskAssessment.identifier"/>
      <short value="Unique identifier for the assessment"/>
      <definition value="Business identifier assigned to the risk assessment."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Identifier"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".id"/>
      </mapping>
      <mapping>
        <identity value="openehr"/>
        <map value="Workflow Identifier"/>
      </mapping>
    </element>
    <element>
      <path value="RiskAssessment.method"/>
      <short value="Evaluation mechanism"/>
      <definition value="The algorithm, processs or mechanism used to evaluate the risk."/>
      <requirements value="The method can influence the results of the assessment."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <binding>
        <name value="RiskAssessmentMethod"/>
        <isExtensible value="true"/>
        <conformance value="example"/>
        <description value="The mechanism or algorithm used to make the assessment.  E.g. TIMI, PRISM, Cardiff Type
         2 diabetes, etc."/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".methodCode"/>
      </mapping>
    </element>
    <element>
      <path value="RiskAssessment.basis"/>
      <short value="Information used in assessment"/>
      <definition value="Indicates the source data considered as part of the assessment (FamilyHistory, Observations,
       Procedures, Conditions, etc.)."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/Profile/Any"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=DRIV].target"/>
      </mapping>
      <mapping>
        <identity value="openehr"/>
        <map value="Risk Factor; Link to Evidence"/>
      </mapping>
    </element>
    <element>
      <path value="RiskAssessment.prediction"/>
      <short value="Outcome predicted"/>
      <definition value="Describes the expected outcome for the subject."/>
      <comments value="Multiple repetitions can be used to identify the same type of outcome in different timeframes
       as well as different types of outcomes."/>
      <min value="0"/>
      <max value="*"/>
      <mustSupport value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=VALUE].target[classCod=OBS, moodCode=RISK]"/>
      </mapping>
    </element>
    <element>
      <path value="RiskAssessment.prediction.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="id"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="RiskAssessment.prediction.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="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."/>
      <comments value="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."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="RiskAssessment.prediction.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="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."/>
      <comments value="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."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <synonym value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="RiskAssessment.prediction.outcome"/>
      <short value="Possible outcome for the subject"/>
      <definition value="One of the potential outcomes for the patient (e.g. remission, death,  a particular condition)."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
      <binding>
        <name value="RiskAssessmentOutcome"/>
        <isExtensible value="true"/>
        <conformance value="example"/>
        <description value="The condition or other outcome.  E.g. death, remission, amputation, infection, etc."/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".value"/>
      </mapping>
      <mapping>
        <identity value="openehr"/>
        <map value="Risk"/>
      </mapping>
    </element>
    <element>
      <path value="RiskAssessment.prediction.probability[x]"/>
      <short value="Likelihood of specified outcome"/>
      <definition value="How likely is the outcome (in the specified timeframe)."/>
      <comments value="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)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="decimal"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ras-1"/>
        <name value="Probability Range Percentage"/>
        <severity value="error"/>
        <human value="low and high must be percentages, if present"/>
        <xpath value="(not(f:low) or f:low[f:code/@value='%' and f:system/@value='http://unitsofmeasure.org'])
         and (not(f:high) or f:high[f:code/@value='%' and f:system/@value='http://unitsofmeasure.org'])"/>
      </constraint>
      <constraint>
        <key value="ras-2"/>
        <name value="Probability percentage"/>
        <severity value="error"/>
        <human value="Must be &lt;= 100"/>
        <xpath value="@value &lt;= 100"/>
      </constraint>
      <binding>
        <name value="RiskAssessmentProbability"/>
        <isExtensible value="true"/>
        <conformance value="example"/>
        <description value="The likelihood of the occurrence of a specified outcome"/>
        <referenceReference>
          <reference value="http://hl7.org/fhir/vs/risk-probability"/>
        </referenceReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;probability&quot;
        ].value"/>
      </mapping>
      <mapping>
        <identity value="openehr"/>
        <map value="Category"/>
      </mapping>
    </element>
    <element>
      <path value="RiskAssessment.prediction.relativeRisk"/>
      <short value="Relative likelihood"/>
      <definition value="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.)."/>
      <requirements value="Absolute risk is less meaningful than relative risk."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="decimal"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;relative
         risk&quot;].value"/>
      </mapping>
    </element>
    <element>
      <path value="RiskAssessment.prediction.when[x]"/>
      <short value="Timeframe or age range"/>
      <definition value="Indicates the period of time or age range of the subject to which the specified probability
       applies."/>
      <comments value="If not specified, the risk applies &quot;over the subject's lifespan&quot;."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Period"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN,
         code=&quot;age&quot;].value"/>
      </mapping>
    </element>
    <element>
      <path value="RiskAssessment.prediction.rationale"/>
      <short value="Explanation of prediction"/>
      <definition value="Additional information explaining the basis for the prediction."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".reasonCode.text"/>
      </mapping>
      <mapping>
        <identity value="openehr"/>
        <map value="Rationale"/>
      </mapping>
    </element>
    <element>
      <path value="RiskAssessment.mitigation"/>
      <short value="How to reduce risk"/>
      <definition value="A description of the steps that might be taken to reduce the identified risk(s)."/>
      <requirements value="One of the main reasons for assessing risks is to identify whether interventional steps
       are needed to reduce risk."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=MTGT].target[classCode=ACT, moodCode=EVN].text"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element>
      <path value="RiskAssessment"/>
      <name value="cqf-riskassessment"/>
      <min value="1"/>
      <max value="1"/>
    </element>
    <element>
      <path value="RiskAssessment.subject"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/Profile/Patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/Profile/Group"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="RiskAssessment.date"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="dateTime"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="RiskAssessment.condition"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/Profile/Condition"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="RiskAssessment.performer"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/Profile/Practitioner"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/Profile/Device"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="RiskAssessment.method"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="RiskAssessment.basis"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/Profile/Any"/>
      </type>
    </element>
    <element>
      <path value="RiskAssessment.prediction"/>
      <min value="0"/>
      <max value="*"/>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="RiskAssessment.prediction.outcome"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="RiskAssessment.prediction.probability[x]"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="decimal"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="CodeableConcept"/>
      </type>
    </element>
    <element>
      <path value="RiskAssessment.prediction.relativeRisk"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="decimal"/>
      </type>
    </element>
    <element>
      <path value="RiskAssessment.prediction.when[x]"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Period"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <mustSupport value="true"/>
    </element>
  </differential>
</Profile>