STU 3 Candidate

This page is part of the FHIR Specification (v1.4.0: STU 3 Ballot 3). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3

Guidanceresponse.profile.json

Raw JSON (canonical form)

StructureDefinition for guidanceresponse

{
  "resourceType": "StructureDefinition",
  "id": "GuidanceResponse",
  "meta": {
    "lastUpdated": "2016-03-31T08:01:25.570+11:00"
  },
  "text": {
    "status": "generated",
    "div": "<div>!-- Snipped for Brevity --></div>"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger": 0
    }
  ],
  "url": "http://hl7.org/fhir/StructureDefinition/GuidanceResponse",
  "name": "GuidanceResponse",
  "status": "draft",
  "publisher": "Health Level Seven International (Clinical Decision Support)",
  "contact": [
    {
      "telecom": [
        {
          "system": "other",
          "value": "http://hl7.org/fhir"
        }
      ]
    },
    {
      "telecom": [
        {
          "system": "other",
          "value": "http://www.hl7.org/Special/committees/dss/index.cfm"
        }
      ]
    }
  ],
  "date": "2016-03-31T08:01:25+11:00",
  "description": "Base StructureDefinition for GuidanceResponse Resource",
  "fhirVersion": "1.4.0",
  "mapping": [
    {
      "identity": "w5",
      "uri": "http://hl7.org/fhir/w5",
      "name": "W5 Mapping"
    },
    {
      "identity": "rim",
      "uri": "http://hl7.org/v3",
      "name": "RIM"
    }
  ],
  "kind": "resource",
  "abstract": false,
  "baseType": "DomainResource",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/DomainResource",
  "derivation": "specialization",
  "snapshot": {
    "element": [
      {
        "path": "GuidanceResponse",
        "short": "The formal response to a guidance request",
        "definition": "A guidance response is the formal response to a guidance request, including any output parameters returned by the evaluation, as well as the description of any proposed actions to be taken.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "DomainResource"
          }
        ],
        "mapping": [
          {
            "identity": "w5",
            "map": "clinical.general"
          }
        ]
      },
      {
        "path": "GuidanceResponse.id",
        "short": "Logical id of this artifact",
        "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
        "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.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Resource.id",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "id"
          }
        ],
        "isSummary": true
      },
      {
        "path": "GuidanceResponse.meta",
        "short": "Metadata about the resource",
        "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.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Resource.meta",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Meta"
          }
        ],
        "isSummary": true
      },
      {
        "path": "GuidanceResponse.implicitRules",
        "short": "A set of rules under which this content was created",
        "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.",
        "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.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Resource.implicitRules",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "uri"
          }
        ],
        "isModifier": true,
        "isSummary": true
      },
      {
        "path": "GuidanceResponse.language",
        "short": "Language of the resource content",
        "definition": "The base language in which the resource is written.",
        "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).",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Resource.language",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "code"
          }
        ],
        "binding": {
          "strength": "required",
          "description": "A human language.",
          "valueSetUri": "http://tools.ietf.org/html/bcp47"
        }
      },
      {
        "path": "GuidanceResponse.text",
        "short": "Text summary of the resource, for human interpretation",
        "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.",
        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative.",
        "alias": [
          "narrative",
          "html",
          "xhtml",
          "display"
        ],
        "min": 0,
        "max": "1",
        "base": {
          "path": "DomainResource.text",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Narrative"
          }
        ],
        "condition": [
          "dom-1"
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "Act.text?"
          }
        ]
      },
      {
        "path": "GuidanceResponse.contained",
        "short": "Contained, inline Resources",
        "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.",
        "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.",
        "alias": [
          "inline resources",
          "anonymous resources",
          "contained resources"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "DomainResource.contained",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Resource"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "path": "GuidanceResponse.extension",
        "short": "Additional Content defined by implementations",
        "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.",
        "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.",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "DomainResource.extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "path": "GuidanceResponse.modifierExtension",
        "short": "Extensions that cannot be ignored",
        "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.",
        "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.",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "DomainResource.modifierExtension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "isModifier": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "path": "GuidanceResponse.requestId",
        "short": "The id of the request associated with this response, if any",
        "definition": "The id of the request associated with this response. If an id was given as part of the request, it will be reproduced here to enable the requester to more easily identify the response in a multi-request scenario.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ]
      },
      {
        "path": "GuidanceResponse.module",
        "short": "A reference to a knowledge module",
        "definition": "A reference to the knowledge module that was invoked.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/DecisionSupportServiceModule"
            ]
          },
          {
            "code": "Reference",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/DecisionSupportRule"
            ]
          }
        ],
        "isModifier": true,
        "isSummary": true
      },
      {
        "path": "GuidanceResponse.status",
        "short": "success | data-requested | data-required | in-progress | failure",
        "definition": "The status of the response. If the evaluation is completed successfully, the status will indicate success. However, in order to complete the evaluation, the engine may require more information. In this case, the status will be data-required, and the response will contain a description of the additional required information. If the evaluation completed successfully, but the engine determines that a potentially more accurate response could be provided if more data was available, the status will be data-requested, and the response will contain a description of the additional requested information.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "code"
          }
        ],
        "isModifier": true,
        "isSummary": true,
        "binding": {
          "strength": "required",
          "description": "The status of a guidance response",
          "valueSetReference": {
            "reference": "http://hl7.org/fhir/ValueSet/guidance-response-status"
          }
        }
      },
      {
        "path": "GuidanceResponse.evaluationMessage",
        "short": "Messages resulting from the evaluation of the artifact or artifacts",
        "definition": "Messages resulting from the evaluation of the artifact or artifacts. As part of evaluating the request, the engine may produce informational or warning messages. These messages will be provided by this element.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Reference",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/OperationOutcome"
            ]
          }
        ]
      },
      {
        "path": "GuidanceResponse.outputParameters",
        "short": "The output parameters of the evaluation, if any",
        "definition": "The output parameters of the evaluation, if any. Many modules will result in the return of specific resources such as procedure or communication requests that are returned as part of the operation result. However, modules may define specific outputs that would be returned as the result of the evaluation, and these would be returned in this element.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/Parameters"
            ]
          }
        ]
      },
      {
        "id": "action",
        "path": "GuidanceResponse.action",
        "short": "Proposed actions, if any",
        "definition": "The actions, if any, produced by the evaluation of the artifact.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "BackboneElement"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.id",
        "representation": [
          "xmlAttr"
        ],
        "short": "xml:id (or equivalent in JSON)",
        "definition": "unique id for the element within a resource (for internal references).",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Element.id",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "id"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.extension",
        "short": "Additional Content defined by implementations",
        "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.",
        "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.",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "Element.extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.modifierExtension",
        "short": "Extensions that cannot be ignored",
        "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.",
        "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.",
        "alias": [
          "extensions",
          "user content",
          "modifiers"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "BackboneElement.modifierExtension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "isModifier": true,
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.actionIdentifier",
        "short": "Unique identifier",
        "definition": "A unique identifier for the action. The identifier SHALL be unique within the container in which it appears, and MAY be universally unique.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Identifier"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.label",
        "short": "User-visible label for the action (e.g. 1. or A.)",
        "definition": "A user-visible label for the action.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.title",
        "short": "User-visible title",
        "definition": "The title of the action displayed to a user.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.description",
        "short": "Short description of the action",
        "definition": "A short description of the action used to provide a summary to display to the user.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.textEquivalent",
        "short": "Static text equivalent of the action, used if the dynamic aspects cannot be interpreted by the receiving system",
        "definition": "A text equivalent of the action to be performed. This provides a human-interpretable description of the action when the definition is consumed by a system that may not be capable of interpreting it dynamically.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.concept",
        "short": "The meaning of the action or its sub-actions",
        "definition": "The concept represented by this action or its sub-actions.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.supportingEvidence",
        "short": "Evidence that supports taking the action",
        "definition": "The evidence grade and the sources of evidence for this action.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Attachment"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.relatedAction",
        "short": "Relationship to another action",
        "definition": "A relationship to another action such as \"before\" or \"30-60 minutes after start of\".",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "BackboneElement"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.relatedAction.id",
        "representation": [
          "xmlAttr"
        ],
        "short": "xml:id (or equivalent in JSON)",
        "definition": "unique id for the element within a resource (for internal references).",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Element.id",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "id"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.relatedAction.extension",
        "short": "Additional Content defined by implementations",
        "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.",
        "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.",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "Element.extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.relatedAction.modifierExtension",
        "short": "Extensions that cannot be ignored",
        "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.",
        "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.",
        "alias": [
          "extensions",
          "user content",
          "modifiers"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "BackboneElement.modifierExtension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "isModifier": true,
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.relatedAction.actionIdentifier",
        "short": "Identifier of the related action",
        "definition": "The unique identifier of the related action.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "Identifier"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.relatedAction.relationship",
        "short": "before | after",
        "definition": "The relationship of this action to the related action.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "code"
          }
        ],
        "binding": {
          "strength": "required",
          "description": "Defines the types of relationships between actions",
          "valueSetReference": {
            "reference": "http://hl7.org/fhir/ValueSet/action-relationship-type"
          }
        }
      },
      {
        "path": "GuidanceResponse.action.relatedAction.offset[x]",
        "short": "Time offset for the relationship",
        "definition": "A duration or range of durations to apply to the relationship. For example, 30-60 minutes before.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Quantity",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/Duration"
            ]
          },
          {
            "code": "Range"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.relatedAction.anchor",
        "short": "start | end",
        "definition": "An optional indicator for how the relationship is anchored to the related action. For example \"before the start\" or \"before the end\" of the related action.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "code"
          }
        ],
        "binding": {
          "strength": "required",
          "description": "Defines possible anchors for the relationship between actions",
          "valueSetReference": {
            "reference": "http://hl7.org/fhir/ValueSet/action-relationship-anchor"
          }
        }
      },
      {
        "path": "GuidanceResponse.action.documentation",
        "short": "Supporting documentation for the intended performer of the action",
        "definition": "Didactic or other informational resources associated with the action that can be provided to the CDS recipient. Information resources can include inline text commentary and links to web resources.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Attachment"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.participant",
        "short": "Participant",
        "definition": "The participant in the action.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Reference",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/Patient"
            ]
          },
          {
            "code": "Reference",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/Person"
            ]
          },
          {
            "code": "Reference",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/Practitioner"
            ]
          },
          {
            "code": "Reference",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
            ]
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.type",
        "short": "create | update | remove | fire-event",
        "definition": "The type of action to perform (create, update, remove).",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "code"
          }
        ],
        "binding": {
          "strength": "required",
          "description": "The type of action to be performed",
          "valueSetReference": {
            "reference": "http://hl7.org/fhir/ValueSet/action-type"
          }
        }
      },
      {
        "path": "GuidanceResponse.action.behavior",
        "short": "Defines behaviors such as selection and grouping",
        "definition": "A behavior associated with the action. Behaviors define how the action is to be presented and/or executed within the receiving environment.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "BackboneElement"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.behavior.id",
        "representation": [
          "xmlAttr"
        ],
        "short": "xml:id (or equivalent in JSON)",
        "definition": "unique id for the element within a resource (for internal references).",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Element.id",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "id"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.behavior.extension",
        "short": "Additional Content defined by implementations",
        "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.",
        "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.",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "Element.extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.behavior.modifierExtension",
        "short": "Extensions that cannot be ignored",
        "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.",
        "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.",
        "alias": [
          "extensions",
          "user content",
          "modifiers"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "BackboneElement.modifierExtension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "isModifier": true,
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.behavior.type",
        "short": "The type of behavior (grouping, precheck, selection, cardinality, etc)",
        "definition": "The type of the behavior to be described, such as grouping, visual, or selection behaviors.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "Coding"
          }
        ],
        "binding": {
          "strength": "required",
          "description": "The type of behavior to be defined",
          "valueSetReference": {
            "reference": "http://hl7.org/fhir/ValueSet/action-behavior-type"
          }
        }
      },
      {
        "path": "GuidanceResponse.action.behavior.value",
        "short": "Specific behavior (e.g. required, at-most-one, single, etc)",
        "definition": "The specific behavior. The code used here is determined by the type of behavior being described. For example, the grouping behavior uses the grouping-behavior-type valueset.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "Coding"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.resource",
        "short": "The target of the action",
        "definition": "The resource that is the target of the action (e.g. CommunicationRequest).",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/Resource"
            ]
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.action",
        "short": "Sub action",
        "definition": "Sub actions.",
        "min": 0,
        "max": "*",
        "contentReference": "#action"
      },
      {
        "path": "GuidanceResponse.dataRequirement",
        "short": "Additional required data",
        "definition": "If the evaluation could not be completed due to lack of information, or additional information would potentially result in a more accurate response, this element will a description of the data required in order to proceed with the evaluation. A subsequent request to the service should include this data.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "DataRequirement"
          }
        ]
      }
    ]
  },
  "differential": {
    "element": [
      {
        "path": "GuidanceResponse",
        "short": "The formal response to a guidance request",
        "definition": "A guidance response is the formal response to a guidance request, including any output parameters returned by the evaluation, as well as the description of any proposed actions to be taken.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "DomainResource"
          }
        ],
        "mapping": [
          {
            "identity": "w5",
            "map": "clinical.general"
          }
        ]
      },
      {
        "path": "GuidanceResponse.requestId",
        "short": "The id of the request associated with this response, if any",
        "definition": "The id of the request associated with this response. If an id was given as part of the request, it will be reproduced here to enable the requester to more easily identify the response in a multi-request scenario.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ]
      },
      {
        "path": "GuidanceResponse.module",
        "short": "A reference to a knowledge module",
        "definition": "A reference to the knowledge module that was invoked.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/DecisionSupportServiceModule"
            ]
          },
          {
            "code": "Reference",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/DecisionSupportRule"
            ]
          }
        ],
        "isModifier": true,
        "isSummary": true
      },
      {
        "path": "GuidanceResponse.status",
        "short": "success | data-requested | data-required | in-progress | failure",
        "definition": "The status of the response. If the evaluation is completed successfully, the status will indicate success. However, in order to complete the evaluation, the engine may require more information. In this case, the status will be data-required, and the response will contain a description of the additional required information. If the evaluation completed successfully, but the engine determines that a potentially more accurate response could be provided if more data was available, the status will be data-requested, and the response will contain a description of the additional requested information.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "code"
          }
        ],
        "isModifier": true,
        "isSummary": true,
        "binding": {
          "strength": "required",
          "description": "The status of a guidance response",
          "valueSetReference": {
            "reference": "http://hl7.org/fhir/ValueSet/guidance-response-status"
          }
        }
      },
      {
        "path": "GuidanceResponse.evaluationMessage",
        "short": "Messages resulting from the evaluation of the artifact or artifacts",
        "definition": "Messages resulting from the evaluation of the artifact or artifacts. As part of evaluating the request, the engine may produce informational or warning messages. These messages will be provided by this element.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Reference",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/OperationOutcome"
            ]
          }
        ]
      },
      {
        "path": "GuidanceResponse.outputParameters",
        "short": "The output parameters of the evaluation, if any",
        "definition": "The output parameters of the evaluation, if any. Many modules will result in the return of specific resources such as procedure or communication requests that are returned as part of the operation result. However, modules may define specific outputs that would be returned as the result of the evaluation, and these would be returned in this element.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/Parameters"
            ]
          }
        ]
      },
      {
        "id": "action",
        "path": "GuidanceResponse.action",
        "short": "Proposed actions, if any",
        "definition": "The actions, if any, produced by the evaluation of the artifact.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "BackboneElement"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.actionIdentifier",
        "short": "Unique identifier",
        "definition": "A unique identifier for the action. The identifier SHALL be unique within the container in which it appears, and MAY be universally unique.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Identifier"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.label",
        "short": "User-visible label for the action (e.g. 1. or A.)",
        "definition": "A user-visible label for the action.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.title",
        "short": "User-visible title",
        "definition": "The title of the action displayed to a user.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.description",
        "short": "Short description of the action",
        "definition": "A short description of the action used to provide a summary to display to the user.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.textEquivalent",
        "short": "Static text equivalent of the action, used if the dynamic aspects cannot be interpreted by the receiving system",
        "definition": "A text equivalent of the action to be performed. This provides a human-interpretable description of the action when the definition is consumed by a system that may not be capable of interpreting it dynamically.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.concept",
        "short": "The meaning of the action or its sub-actions",
        "definition": "The concept represented by this action or its sub-actions.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.supportingEvidence",
        "short": "Evidence that supports taking the action",
        "definition": "The evidence grade and the sources of evidence for this action.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Attachment"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.relatedAction",
        "short": "Relationship to another action",
        "definition": "A relationship to another action such as \"before\" or \"30-60 minutes after start of\".",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "BackboneElement"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.relatedAction.actionIdentifier",
        "short": "Identifier of the related action",
        "definition": "The unique identifier of the related action.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "Identifier"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.relatedAction.relationship",
        "short": "before | after",
        "definition": "The relationship of this action to the related action.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "code"
          }
        ],
        "binding": {
          "strength": "required",
          "description": "Defines the types of relationships between actions",
          "valueSetReference": {
            "reference": "http://hl7.org/fhir/ValueSet/action-relationship-type"
          }
        }
      },
      {
        "path": "GuidanceResponse.action.relatedAction.offset[x]",
        "short": "Time offset for the relationship",
        "definition": "A duration or range of durations to apply to the relationship. For example, 30-60 minutes before.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Quantity",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/Duration"
            ]
          },
          {
            "code": "Range"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.relatedAction.anchor",
        "short": "start | end",
        "definition": "An optional indicator for how the relationship is anchored to the related action. For example \"before the start\" or \"before the end\" of the related action.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "code"
          }
        ],
        "binding": {
          "strength": "required",
          "description": "Defines possible anchors for the relationship between actions",
          "valueSetReference": {
            "reference": "http://hl7.org/fhir/ValueSet/action-relationship-anchor"
          }
        }
      },
      {
        "path": "GuidanceResponse.action.documentation",
        "short": "Supporting documentation for the intended performer of the action",
        "definition": "Didactic or other informational resources associated with the action that can be provided to the CDS recipient. Information resources can include inline text commentary and links to web resources.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Attachment"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.participant",
        "short": "Participant",
        "definition": "The participant in the action.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Reference",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/Patient"
            ]
          },
          {
            "code": "Reference",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/Person"
            ]
          },
          {
            "code": "Reference",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/Practitioner"
            ]
          },
          {
            "code": "Reference",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
            ]
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.type",
        "short": "create | update | remove | fire-event",
        "definition": "The type of action to perform (create, update, remove).",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "code"
          }
        ],
        "binding": {
          "strength": "required",
          "description": "The type of action to be performed",
          "valueSetReference": {
            "reference": "http://hl7.org/fhir/ValueSet/action-type"
          }
        }
      },
      {
        "path": "GuidanceResponse.action.behavior",
        "short": "Defines behaviors such as selection and grouping",
        "definition": "A behavior associated with the action. Behaviors define how the action is to be presented and/or executed within the receiving environment.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "BackboneElement"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.behavior.type",
        "short": "The type of behavior (grouping, precheck, selection, cardinality, etc)",
        "definition": "The type of the behavior to be described, such as grouping, visual, or selection behaviors.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "Coding"
          }
        ],
        "binding": {
          "strength": "required",
          "description": "The type of behavior to be defined",
          "valueSetReference": {
            "reference": "http://hl7.org/fhir/ValueSet/action-behavior-type"
          }
        }
      },
      {
        "path": "GuidanceResponse.action.behavior.value",
        "short": "Specific behavior (e.g. required, at-most-one, single, etc)",
        "definition": "The specific behavior. The code used here is determined by the type of behavior being described. For example, the grouping behavior uses the grouping-behavior-type valueset.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "Coding"
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.resource",
        "short": "The target of the action",
        "definition": "The resource that is the target of the action (e.g. CommunicationRequest).",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/Resource"
            ]
          }
        ]
      },
      {
        "path": "GuidanceResponse.action.action",
        "short": "Sub action",
        "definition": "Sub actions.",
        "min": 0,
        "max": "*",
        "contentReference": "#action"
      },
      {
        "path": "GuidanceResponse.dataRequirement",
        "short": "Additional required data",
        "definition": "If the evaluation could not be completed due to lack of information, or additional information would potentially result in a more accurate response, this element will a description of the data required in order to proceed with the evaluation. A subsequent request to the service should include this data.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "DataRequirement"
          }
        ]
      }
    ]
  }
}

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.