2nd DSTU Draft For Comment

This page is part of the FHIR Specification (v0.4.0: DSTU 2 Draft). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions

Profile CCDA Cognitive Statuses - Definitions

Todo

Definitions for the list-ccda-cognitivestatuses-ccdacognitivestatuses Profile.

List(CCDACognitiveStatuses)
Definition

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

Control1..1
Requirements
Alternate NamesCollection, WorkingList, Organizer
Comments
InvariantsDefined on this element
lst-1: A list can only have an emptyReason if it is empty (xpath: not(exists(f:emptyReason) and exists(f:entry)))
lst-2: The deleted flag can only be used if the mode of the list is "changes" (xpath: (f:mode/@value = 'changes') or not(exists(f:entry/f:item/f:deleted)))
List.id
Definition

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

Control0..1
Typeid
Requirements
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. Bundles always have an id, though it is usually a generated UUID.

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
Requirements
Comments
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
Requirements
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 as much as possible.

List.language
Definition

The base language in which the resource is written.

Control0..1
BindingA human language
The codes SHALL be taken from http://tools.ietf.org/html/bcp47
Typecode
Requirements
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).

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
Requirements
Alternate Namesnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative.

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
Requirements
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.

List.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
Requirements
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. The slicing rules are:
  • unordered
  • open
  • discriminators: url
List.extension(ListStatus)
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.

Control1..1
Typecode
Requirements
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.

Fixed Valuefinal
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
Requirements
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.

List.identifier
Definition

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

Control1..*
TypeIdentifier
Requirements
Comments
List.identifier.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
Requirements
Comments
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
Requirements
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. The slicing rules are:
  • unordered
  • open
  • discriminators: url
List.identifier.extension (http://hl7.org/fhir/ExtensionDefinition/data-absent-reason)
Definition

Provides a reason why the expected value or elements in the element that is extended are missing.

Control0..1
BindingUsed to specify why the normally expected content of the data element is missing
For codes, see DataAbsentReason
Typecode
Requirements
Comments
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.

List.identifier.label
Definition

A text string for the identifier that can be displayed to a human so they can recognize the identifier.

Control0..1
Typestring
Requirements

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

Comments
List.identifier.system
Definition

Establishes the namespace in which set of possible id values is unique.

Control0..1
Typeuri
Requirements

There are many sequences of identifiers. To perform matching, we need to know what sequence we're dealing with. The system identifies a particular sequence or set of unique identifiers.

Comments
Examplehttp://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the id itself is a full uri
List.identifier.value
Definition

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

Control0..1
Typestring
Requirements
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.

Example123456
List.identifier.period
Definition

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

Control0..1
TypePeriod
Requirements
Comments
List.identifier.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(Profile = (Profile = http://hl7.org/fhir/Profile/Organization))
Requirements
Comments

The reference may be just a text description of the assigner.

List.code
Definition

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

Control1..1
BindingCodes defining the purpose of the list
For codes, see #ListPurposeCodes
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.

List.code.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
Requirements
Comments
List.code.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
Requirements
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. The slicing rules are:
  • unordered
  • open
  • discriminators: url
List.code.extension (http://hl7.org/fhir/ExtensionDefinition/data-absent-reason)
Definition

Provides a reason why the expected value or elements in the element that is extended are missing.

Control0..1
BindingUsed to specify why the normally expected content of the data element is missing
For codes, see DataAbsentReason
Typecode
Requirements
Comments
List.code.coding
Definition

A reference to a code defined by a terminology system.

Control0..*
TypeCoding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the V3 Core Principles for more information. Ordering of codings is undefined and SHALL not be used to infer meaning.

List.code.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control0..1
Typestring
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

List.subject
Definition

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

Control0..1
TypeChoice of: Reference(Profile = (Profile = http://hl7.org/fhir/Profile/Patient)), Reference(Profile = (Profile = http://hl7.org/fhir/Profile/Group)), Reference(Profile = (Profile = http://hl7.org/fhir/Profile/Device)), Reference(Profile = (Profile = http://hl7.org/fhir/Profile/Location))
Requirements

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

Comments

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

List.source
Definition

The entity responsible for deciding what the contents of the list were.

Control0..1
TypeChoice of: Reference(Profile = (Profile = http://hl7.org/fhir/Profile/Practitioner)), Reference(Profile = (Profile = http://hl7.org/fhir/Profile/Patient)), Reference(Profile = (Profile = http://hl7.org/fhir/Profile/Device))
Requirements

Allows follow-up as well as context.

Comments

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

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.

List.ordered
Definition

Whether items in the list have a meaningful order.

Control0..1
Typeboolean
Is Modifiertrue
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. This is marked as "is modifier" because whether the list is ordered or not may change how the results are processed or displayed.

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
List.entry
Definition

Entries in this list.

Control1..* This element is affected by the following invariants: lst-1
Requirements
Comments

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

List.entry.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
Requirements
Comments
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
Requirements
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.

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
Requirements
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.

List.entry.flag
Definition

The flag allows the system constructing the list to make one or more statements about the role and significance of the item in the list.

Control0..*
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".

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.

Default Valuefalse
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".

List.entry.item
Definition

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

Control1..1
TypeReference(Profile = http://hl7.org/fhir/Profile/CCDACognitiveStatusResult)
Requirements
Comments
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
BindingIf a list is empty, why it is empty
The codes SHOULD be taken from List Empty Reasons; other codes may be used where these codes are not suitable
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.