Contraindication.profile.xml

StructureDefinition for contraindication

Raw XML

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="Contraindication"/>
  <meta>
    <lastUpdated value="2015-04-03T14:24:32.000+11:00"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><!-- Snipped for brevity --></div>
  </text>
  <url value="http://hl7.org/fhir/StructureDefinition/Contraindication"/>
  <name value="Contraindication"/>
  <publisher value="HL7 FHIR Project (Clinical Decision Support)"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://hl7.org/fhir"/>
    </telecom>
  </contact>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/dss/index.cfm"/>
    </telecom>
  </contact>
  <description value="Base StructureDefinition for Contraindication Resource"/>
  <status value="draft"/>
  <date value="2015-04-03T14:24:32+11:00"/>
  <mapping>
    <identity value="v2"/>
    <uri value="http://hl7.org/v2"/>
    <name value="HL7 v2"/>
  </mapping>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM"/>
  </mapping>
  <type value="resource"/>
  <abstract value="true"/>
  <snapshot>
    <element>
      <path value="Contraindication"/>
      <short value="Clinical issue with action"/>
      <definition value="Indicates an actual or potential clinical issue with or between one or more active or
       proposed clinical actions for a patient.  E.g. Drug-drug interaction, Ineffective treatment
       frequency, Procedure-condition conflict, etc."/>
      <alias value="DDI"/>
      <alias value="drug-drug interaction"/>
      <alias value="DetectedIssue"/>
      <alias value="Alert"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="DomainResource"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Observation[classCode=ALRT, moodCode=EVN)"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.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="Contraindication.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="Contraindication.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="Contraindication.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"/>
        <strength value="required"/>
        <description value="A human language"/>
        <valueSetUri value="http://tools.ietf.org/html/bcp47"/>
      </binding>
    </element>
    <element>
      <path value="Contraindication.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."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias 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="Contraindication.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."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias 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="Contraindication.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."/>
      <alias value="extensions"/>
      <alias 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="Contraindication.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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.patient"/>
      <short value="Associated patient"/>
      <definition value="Indicates the patient whose record the contraindication is associated with."/>
      <requirements value="While the subject could be inferred by tracing the subject of the implicated resources,
       it's useful to have a direct link for query purposes."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=SBJ].role[classCode=PAT]"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.category"/>
      <short value="E.g. Drug-drug, duplicate therapy, etc."/>
      <definition value="Identifies the general type of issue identified."/>
      <alias value="type"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <name value="ContraindicationCategory"/>
        <strength value="required"/>
        <description value="Codes identifying the general type of contraindication.  E.g. Drug-drug interaction, Timing
         issue, Duplicate therapy, etc."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/vs/contraindication-category"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".code"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.severity"/>
      <short value="high | medium | low"/>
      <definition value="Indicates the degree of importance associated with the identified issue based on the potential
       impact on the patient."/>
      <alias value="severity"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <name value="ContraindicationSeverity"/>
        <strength value="required"/>
        <description value="Indicates the potential degree of impact of the identified issue on the patient"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/v3/vs/SeverityObservation"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV].value"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.implicated"/>
      <short value="Problem resource"/>
      <definition value="Indicates the resource representing the current activity or proposed activity that."/>
      <comments value="There's an implicit constraint on the number of implicated resources based on Contraindication.type.
        E.g. For drug-drug, there would be more than one.  For timing, there would typically
       only be one."/>
      <alias value="cause"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Resource"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=SUBJ].target[moodCode=EVN, INT]"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.detail"/>
      <short value="Description and context"/>
      <definition value="A textual explanation of the contraindication."/>
      <comments value="Should focus on information not covered elsewhere as discrete data - no need to duplicate
       the narrative."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".text"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.date"/>
      <short value="When identified"/>
      <definition value="The date or date-time when the contraindication was initially identified."/>
      <requirements value="No-one can be responsible for mitigation prior to the issue being identified."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="dateTime"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.author"/>
      <short value="Who found issue?"/>
      <definition value="Identifies the provider or software that identified the."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Device"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=AUT].role[classCode=ASSIGNED]"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.identifier"/>
      <short value="Unique id for the contraindication"/>
      <definition value="Business identifier associated with the contraindication record."/>
      <requirements value="Allows linking instances of the same contraindication found on different servers."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Identifier"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".id"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.reference"/>
      <short value="Authority for issue"/>
      <definition value="The literature, knowledge-base or similar reference that describes the propensity for
       the contraindication identified."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="uri"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=INST].target[classCode=ALRT, moodCode=DEFN].text.uri"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.mitigation"/>
      <short value="Step taken to address"/>
      <definition value="Indicates an action that has been taken or is committed to to reduce or eliminate the
       likelihood of the risk identified by the contraindicaiton from manifesting.  Can also
       reflect an observation of known mitigating factors that may reduce/eliminate the need
       for any action."/>
      <min value="0"/>
      <max value="*"/>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=MITG].target[classCode=ACT, moodCode=EVN]"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.mitigation.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="Contraindication.mitigation.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."/>
      <alias value="extensions"/>
      <alias 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="Contraindication.mitigation.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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.mitigation.action"/>
      <short value="What mitigation?"/>
      <definition value="Describes the action that was taken or the observation that was made that reduces/eliminates
       the risk associated with the identified contraindication."/>
      <comments value="The &quot;text&quot; component can be used for detail or when no appropriate code exists."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <name value="ContraindicationMitigationAction"/>
        <strength value="required"/>
        <description value="Codes describing steps taken to resolve the contraindication or other circumstances that
         mitigate the risk associated with the contraindication.  E.g. 'added concurrent therapy',
         'prior therapy documented', etc."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/vs/contraindication-mitigation-action"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".code"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.mitigation.date"/>
      <short value="Date committed"/>
      <definition value="Indicates when the mitigating action was documented."/>
      <comments value="This may not be the same as when the mitigating step was actually taken."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="dateTime"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.mitigation.author"/>
      <short value="Who is committing?"/>
      <definition value="Identifies the practitioner who determined the mitigation and takes responsibility for
       the mitigation step occurring."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=AUT].role[classCode=ASSIGNED]"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element>
      <path value="Contraindication"/>
      <short value="Clinical issue with action"/>
      <definition value="Indicates an actual or potential clinical issue with or between one or more active or
       proposed clinical actions for a patient.  E.g. Drug-drug interaction, Ineffective treatment
       frequency, Procedure-condition conflict, etc."/>
      <alias value="DDI"/>
      <alias value="drug-drug interaction"/>
      <alias value="DetectedIssue"/>
      <alias value="Alert"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="DomainResource"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Observation[classCode=ALRT, moodCode=EVN)"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.patient"/>
      <short value="Associated patient"/>
      <definition value="Indicates the patient whose record the contraindication is associated with."/>
      <requirements value="While the subject could be inferred by tracing the subject of the implicated resources,
       it's useful to have a direct link for query purposes."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=SBJ].role[classCode=PAT]"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.category"/>
      <short value="E.g. Drug-drug, duplicate therapy, etc."/>
      <definition value="Identifies the general type of issue identified."/>
      <alias value="type"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <name value="ContraindicationCategory"/>
        <strength value="required"/>
        <description value="Codes identifying the general type of contraindication.  E.g. Drug-drug interaction, Timing
         issue, Duplicate therapy, etc."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/vs/contraindication-category"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".code"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.severity"/>
      <short value="high | medium | low"/>
      <definition value="Indicates the degree of importance associated with the identified issue based on the potential
       impact on the patient."/>
      <alias value="severity"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <name value="ContraindicationSeverity"/>
        <strength value="required"/>
        <description value="Indicates the potential degree of impact of the identified issue on the patient"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/v3/vs/SeverityObservation"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV].value"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.implicated"/>
      <short value="Problem resource"/>
      <definition value="Indicates the resource representing the current activity or proposed activity that."/>
      <comments value="There's an implicit constraint on the number of implicated resources based on Contraindication.type.
        E.g. For drug-drug, there would be more than one.  For timing, there would typically
       only be one."/>
      <alias value="cause"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Resource"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=SUBJ].target[moodCode=EVN, INT]"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.detail"/>
      <short value="Description and context"/>
      <definition value="A textual explanation of the contraindication."/>
      <comments value="Should focus on information not covered elsewhere as discrete data - no need to duplicate
       the narrative."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".text"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.date"/>
      <short value="When identified"/>
      <definition value="The date or date-time when the contraindication was initially identified."/>
      <requirements value="No-one can be responsible for mitigation prior to the issue being identified."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="dateTime"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.author"/>
      <short value="Who found issue?"/>
      <definition value="Identifies the provider or software that identified the."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Device"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=AUT].role[classCode=ASSIGNED]"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.identifier"/>
      <short value="Unique id for the contraindication"/>
      <definition value="Business identifier associated with the contraindication record."/>
      <requirements value="Allows linking instances of the same contraindication found on different servers."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Identifier"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".id"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.reference"/>
      <short value="Authority for issue"/>
      <definition value="The literature, knowledge-base or similar reference that describes the propensity for
       the contraindication identified."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="uri"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=INST].target[classCode=ALRT, moodCode=DEFN].text.uri"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.mitigation"/>
      <short value="Step taken to address"/>
      <definition value="Indicates an action that has been taken or is committed to to reduce or eliminate the
       likelihood of the risk identified by the contraindicaiton from manifesting.  Can also
       reflect an observation of known mitigating factors that may reduce/eliminate the need
       for any action."/>
      <min value="0"/>
      <max value="*"/>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=MITG].target[classCode=ACT, moodCode=EVN]"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.mitigation.action"/>
      <short value="What mitigation?"/>
      <definition value="Describes the action that was taken or the observation that was made that reduces/eliminates
       the risk associated with the identified contraindication."/>
      <comments value="The &quot;text&quot; component can be used for detail or when no appropriate code exists."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <name value="ContraindicationMitigationAction"/>
        <strength value="required"/>
        <description value="Codes describing steps taken to resolve the contraindication or other circumstances that
         mitigate the risk associated with the contraindication.  E.g. 'added concurrent therapy',
         'prior therapy documented', etc."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/vs/contraindication-mitigation-action"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".code"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.mitigation.date"/>
      <short value="Date committed"/>
      <definition value="Indicates when the mitigating action was documented."/>
      <comments value="This may not be the same as when the mitigating step was actually taken."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="dateTime"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime"/>
      </mapping>
    </element>
    <element>
      <path value="Contraindication.mitigation.author"/>
      <short value="Who is committing?"/>
      <definition value="Identifies the practitioner who determined the mitigation and takes responsibility for
       the mitigation step occurring."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=AUT].role[classCode=ASSIGNED]"/>
      </mapping>
    </element>
  </differential>
</StructureDefinition>