R4 Draft for Comment

This page is part of the FHIR Specification (v3.2.0: R4 Ballot 1). 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

Clinical Decision Support Work GroupMaturity Level: 2 Trial Use Compartments: Not linked to any defined compartments

Detailed Descriptions for the elements in the PlanDefinition resource.

PlanDefinition
Definition

This resource allows for the definition of various types of plans as a sharable, consumable, and executable artifact. The resource is general enough to support the description of a broad range of clinical artifacts such as clinical decision support rules, order sets and protocols.

Control1..1
PlanDefinition.url
Definition

An absolute URI that is used to identify this plan definition when it is referenced in a specification, model, design or an instance. This SHOULD be globally unique, and SHOULD be a literal address at which this plan definition is (or will be) published.

Control0..1
Typeuri
Requirements

Allows the plan definition to be referenced by a single globally unique identifier.

Summarytrue
Comments

Can be a urn:uuid: or a urn:oid:, but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version.

The URL SHOULD include the major version of the plan definition. For more information see Technical and Business Versions.

PlanDefinition.identifier
Definition

A formal identifier that is used to identify this plan definition when it is represented in other formats, or referenced in a specification, model, design or an instance.

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Requirements

Allows externally provided and/or usable business identifiers to be easily associated with the module.

Summarytrue
Comments

Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, e.g., to identify this plan definition outside of FHIR, where it is not possible to use the logical URI.

PlanDefinition.version
Definition

The identifier that is used to identify this version of the plan definition when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the plan definition author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. To provide a version consistent with the Decision Support Service specification, use the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer to the Decision Support Service specification. Note that a version is required for non-experimental active artifacts.

NoteThis is a business versionId, not a resource version id (see discussion)
Control0..1
Typestring
Summarytrue
Comments

There may be different plan definition instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the plan definition with the format [url]|[version].

PlanDefinition.name
Definition

A natural language name identifying the plan definition. This name should be usable as an identifier for the module by machine processing applications such as code generation.

Control0..1
Typestring
Requirements

Support human navigation and code generation.

Summarytrue
Comments

The name is not expected to be globally unique. The name should be a simple alpha-numeric type name to ensure that it is computable friendly.

PlanDefinition.title
Definition

A short, descriptive, user-friendly title for the plan definition.

Control0..1
Typestring
Summarytrue
Comments

This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

PlanDefinition.type
Definition

The type of artifact the plan definition represents, e.g. an order set, protocol, or event-condition-action rule.

Control0..1
Terminology BindingPlanDefinitionType (Extensible)
TypeCodeableConcept
Summarytrue
PlanDefinition.status
Definition

The status of this plan definition. Enables tracking the life-cycle of the content.

Control1..1
Terminology BindingPublicationStatus (Required)
Typecode
Is Modifiertrue
Summarytrue
Comments

Allows filtering of plan definitions that are appropriate for use vs. not.
This is labeled as "Is Modifier" because applications should not use a retired plan definition without due consideration.

PlanDefinition.experimental
Definition

A boolean value to indicate that this plan definition is authored for testing purposes (or education/evaluation/marketing), and is not intended to be used for genuine usage.

Control0..1
Typeboolean
Is Modifiertrue
Requirements

Enables experimental content to be developed following the same lifecycle that would be used for a production-level plan definition.

Summarytrue
Comments

Allows filtering of plan definition that are appropriate for use vs. not. This is labeled as "Is Modifier" because applications should not use an experimental plan definition in production.

PlanDefinition.date
Definition

The date (and optionally time) when the plan definition was published. The date must change if and when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the plan definition changes.

Control0..1
TypedateTime
Alternate NamesRevision Date
Summarytrue
Comments

Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the plan definition. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

PlanDefinition.publisher
Definition

The name of the individual or organization that published the plan definition.

Control0..1
Typestring
Requirements

Helps establish the "authority/credibility" of the plan definition. May also allow for contact.

Summarytrue
Comments

Usually an organization, but may be an individual. The publisher (or steward) of the plan definition is the organization or individual primarily responsible for the maintenance and upkeep of the plan definition. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the plan definition. This item SHOULD be populated unless the information is available from context.

PlanDefinition.description
Definition

A free text natural language description of the plan definition from a consumer's perspective.

Control0..1
Typemarkdown
Summarytrue
Comments

This description can be used to capture details such as why the plan definition was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the plan definition as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the profile is presumed to be the predominant language in the place the profile was created).

PlanDefinition.purpose
Definition

Explaination of why this plan definition is needed and why it has been designed as it has.

Control0..1
Typemarkdown
Comments

This element does not describe the usage of the plan definition Instead it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this plan definition.

PlanDefinition.usage
Definition

A detailed description of how the plan definition is used from a clinical perspective.

Control0..1
Typestring
PlanDefinition.approvalDate
Definition

The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.

Control0..1
Typedate
Comments

The 'date' element may be more recent than the approval date because of minor changes / editorial corrections.

PlanDefinition.lastReviewDate
Definition

The date on which the resource content was last reviewed. Review happens periodically after approval, but doesn't change the original approval date.

Control0..1
Typedate
Requirements

Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant.

Comments

If specified, this is usually after the approval date.

PlanDefinition.effectivePeriod
Definition

The period during which the plan definition content was or is planned to be in active use.

Control0..1
TypePeriod
Requirements

Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of a the plan definition are or are expected to be used instead.

Summarytrue
Comments

The effective period for a plan definition determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015.

PlanDefinition.useContext
Definition

The content was developed with a focus and intent of supporting the contexts that are listed. These terms may be used to assist with indexing and searching for appropriate plan definition instances.

Control0..*
TypeUsageContext
Requirements

Assist in searching for appropriate content.

Summarytrue
Comments

When multiple useContexts are specified, there is no expectation whether all or any of the contexts apply.

PlanDefinition.jurisdiction
Definition

A legal or geographic region in which the plan definition is intended to be used.

Control0..*
Terminology BindingJurisdiction ValueSet (Extensible)
TypeCodeableConcept
Summarytrue
Comments

It may be possible for the plan definition to be used in jurisdictions other than those for which it was originally designed or intended.

PlanDefinition.topic
Definition

Descriptive topics related to the content of the plan definition. Topics provide a high-level categorization of the definition that can be useful for filtering and searching.

Control0..*
Terminology BindingDefinitionTopic (Example)
TypeCodeableConcept
Requirements

Repositories must be able to determine how to categorize the plan definition so that it can be found by topical searches.

PlanDefinition.contributor
Definition

A contributor to the content of the plan definition, including authors, editors, reviewers, and endorsers.

Control0..*
TypeContributor
Requirements

Consumers of the content must be able to quickly determine who contributed to the content of the plan definition.

PlanDefinition.contact
Definition

Contact details to assist a user in finding and communicating with the publisher.

Control0..*
TypeContactDetail
Summarytrue
Comments

May be a web site, an email address, a telephone number, etc.

PlanDefinition.copyright
Definition

A copyright statement relating to the plan definition and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the plan definition.

Control0..1
Typemarkdown
Requirements

Consumers must be able to determine any legal restrictions on the use of the plan definition and/or its content.

Alternate NamesLicense; Restrictions
PlanDefinition.relatedArtifact
Definition

Related artifacts such as additional documentation, justification, or bibliographic references.

Control0..*
TypeRelatedArtifact
Requirements

Plan definitions must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content.

Comments

Each related artifact is either an attachment, or a reference to another resource, but not both.

PlanDefinition.library
Definition

A reference to a Library resource containing any formal logic used by the plan definition.

Control0..*
TypeReference(Library)
PlanDefinition.goal
Definition

Goals that describe what the activities within the plan are intended to achieve. For example, weight loss, restoring an activity of daily living, obtaining herd immunity via immunization, meeting a process improvement objective, etc.

Control0..*
Requirements

Goal information needs to be captured for order sets, protocols, and care plan definitions to better describe the objectives of the protocol activities and to guide the creation of specific goals within the derived care plans and orders.

PlanDefinition.goal.category
Definition

Indicates a category the goal falls within.

Control0..1
Terminology BindingGoalCategory (Example)
TypeCodeableConcept
PlanDefinition.goal.description
Definition

Human-readable and/or coded description of a specific desired objective of care, such as "control blood pressure" or "negotiate an obstacle course" or "dance with child at wedding".

Control1..1
Terminology BindingSNOMED CT Clinical Findings (Example)
TypeCodeableConcept
Comments

If no code is available, use CodeableConcept.text.

PlanDefinition.goal.priority
Definition

Identifies the expected level of importance associated with reaching/sustaining the defined goal.

Control0..1
Terminology BindingGoalPriority (Preferred)
TypeCodeableConcept
PlanDefinition.goal.start
Definition

The event after which the goal should begin being pursued.

Control0..1
Terminology BindingGoalStartEvent (Example)
TypeCodeableConcept
PlanDefinition.goal.addresses
Definition

Identifies problems, conditions, issues, or concerns the goal is intended to address.

Control0..*
Terminology BindingCondition/Problem/Diagnosis Codes (Example)
TypeCodeableConcept
PlanDefinition.goal.documentation
Definition

Didactic or other informational resources associated with the goal that provide further supporting information about the goal. Information resources can include inline text commentary and links to web resources.

Control0..*
TypeRelatedArtifact
PlanDefinition.goal.target
Definition

Indicates what should be done and within what timeframe.

Control0..*
PlanDefinition.goal.target.measure
Definition

The parameter whose value is to be tracked, e.g. body weigth, blood pressure, or hemoglobin A1c level.

Control0..1
Terminology BindingLOINC Codes (Example)
TypeCodeableConcept
PlanDefinition.goal.target.detail[x]
Definition

The target value of the measure to be achieved to signify fulfillment of the goal, e.g. 150 pounds or 7.0%. Either the high or low or both values of the range can be specified. Whan a low value is missing, it indicates that the goal is achieved at any value at or below the high value. Similarly, if the high value is missing, it indicates that the goal is achieved at any value at or above the low value.

Control0..1
TypeQuantity|Range|CodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
PlanDefinition.goal.target.due
Definition

Indicates the timeframe after the start of the goal in which the goal should be met.

Control0..1
TypeDuration
PlanDefinition.action
Definition

An action to be taken as part of the plan.

Control0..*
PlanDefinition.action.prefix
Definition

A user-visible prefix for the action.

Control0..1
Typestring
PlanDefinition.action.title
Definition

The title of the action displayed to a user.

Control0..1
Typestring
PlanDefinition.action.description
Definition

A short description of the action used to provide a summary to display to the user.

Control0..1
Typestring
PlanDefinition.action.textEquivalent
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 might not be capable of interpreting it dynamically.

Control0..1
Typestring
PlanDefinition.action.code
Definition

A code that provides meaning for the action or action group. For example, a section may have a LOINC code for a the section of a documentation template.

Control0..*
TypeCodeableConcept
PlanDefinition.action.reason
Definition

A description of why this action is necessary or appropriate.

Control0..*
TypeCodeableConcept
Comments

This is different than the clinical evidence documentation, it's an actual business description of the reason for performing the action.

PlanDefinition.action.documentation
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.

Control0..*
TypeRelatedArtifact
PlanDefinition.action.goalId
Definition

Identifies goals that this action supports. The reference must be to a goal element defined within this plan definition.

Control0..*
Typeid
PlanDefinition.action.triggerDefinition
Definition

A description of when the action should be triggered.

Control0..*
TypeTriggerDefinition
PlanDefinition.action.condition
Definition

An expression that describes applicability criteria, or start/stop conditions for the action.

Control0..*
PlanDefinition.action.condition.kind
Definition

The kind of condition.

Control1..1
Terminology BindingActionConditionKind (Required)
Typecode
Comments

Applicability criteria are used to determine immediate applicability when a plan definition is applied to a given context. Start and stop criteria are carried through application and used to describe when enter/exit criteria for an action.

PlanDefinition.action.condition.description
Definition

A brief, natural language description of the condition that effectively communicates the intended semantics.

Control0..1
Typestring
PlanDefinition.action.condition.language
Definition

The media type of the language for the expression.

Control0..1
Typestring
PlanDefinition.action.condition.expression
Definition

An expression that returns true or false, indicating whether or not the condition is satisfied.

Control0..1
Typestring
Comments

The expression may be inlined, or may be a reference to a named expression within a logic library referenced by the library element.

PlanDefinition.action.input
Definition

Defines input data requirements for the action.

Control0..*
TypeDataRequirement
PlanDefinition.action.output
Definition

Defines the outputs of the action, if any.

Control0..*
TypeDataRequirement
PlanDefinition.action.relatedAction
Definition

A relationship to another action such as "before" or "30-60 minutes after start of".

Control0..*
Comments

When an action depends on multiple actions, the meaning is that all actions are dependencies, rather than that any of the actions are a dependency.

PlanDefinition.action.relatedAction.actionId
Definition

The element id of the related action.

Control1..1
Typeid
PlanDefinition.action.relatedAction.relationship
Definition

The relationship of this action to the related action.

Control1..1
Terminology BindingActionRelationshipType (Required)
Typecode
PlanDefinition.action.relatedAction.offset[x]
Definition

A duration or range of durations to apply to the relationship. For example, 30-60 minutes before.

Control0..1
TypeDuration|Range
[x] NoteSee Choice of Data Types for further information about how to use [x]
PlanDefinition.action.timing[x]
Definition

An optional value describing when the action should be performed.

Control0..1
TypedateTime|Age|Period|Duration|Range|Timing
[x] NoteSee Choice of Data Types for further information about how to use [x]
PlanDefinition.action.participant
Definition

Indicates who should participate in performing the action described.

Control0..*
PlanDefinition.action.participant.type
Definition

The type of participant in the action.

Control1..1
Terminology BindingActionParticipantType (Required)
Typecode
PlanDefinition.action.participant.role
Definition

The role the participant should play in performing the described action.

Control0..1
Terminology BindingActionParticipantRole (Example)
TypeCodeableConcept
PlanDefinition.action.type
Definition

The type of action to perform (create, update, remove).

Control0..1
Terminology BindingActionType (Required)
TypeCoding
PlanDefinition.action.groupingBehavior
Definition

Defines the grouping behavior for the action and its children.

Control0..1
Terminology BindingActionGroupingBehavior (Required)
Typecode
PlanDefinition.action.selectionBehavior
Definition

Defines the selection behavior for the action and its children.

Control0..1
Terminology BindingActionSelectionBehavior (Required)
Typecode
PlanDefinition.action.requiredBehavior
Definition

Defines the requiredness behavior for the action.

Control0..1
Terminology BindingActionRequiredBehavior (Required)
Typecode
PlanDefinition.action.precheckBehavior
Definition

Defines whether the action should usually be preselected.

Control0..1
Terminology BindingActionPrecheckBehavior (Required)
Typecode
PlanDefinition.action.cardinalityBehavior
Definition

Defines whether the action can be selected multiple times.

Control0..1
Terminology BindingActionCardinalityBehavior (Required)
Typecode
PlanDefinition.action.definition
Definition

A reference to an ActivityDefinition that describes the action to be taken in detail, or a PlanDefinition that describes a series of actions to be taken.

Control0..1
TypeReference(ActivityDefinition | PlanDefinition)
Comments

Note that the definition is optional, and if no definition is specified, a dynamicValue with a root (~) path can be used to define the entire resource dynamically.

PlanDefinition.action.transform
Definition

A reference to a StructureMap resource that defines a transform that can be executed to produce the intent resource using the ActivityDefinition instance as the input.

Control0..1
TypeReference(StructureMap)
PlanDefinition.action.dynamicValue
Definition

Customizations that should be applied to the statically defined resource. For example, if the dosage of a medication must be computed based on the patient's weight, a customization would be used to specify an expression that calculated the weight, and the path on the resource that would contain the result.

Control0..*
PlanDefinition.action.dynamicValue.description
Definition

A brief, natural language description of the intended semantics of the dynamic value.

Control0..1
Typestring
PlanDefinition.action.dynamicValue.path
Definition

The path to the element to be customized. This is the path on the resource that will hold the result of the calculation defined by the expression.

Control0..1
Typestring
PlanDefinition.action.dynamicValue.language
Definition

The media type of the language for the expression.

Control0..1
Typestring
PlanDefinition.action.dynamicValue.expression
Definition

An expression specifying the value of the customized element.

Control0..1
Typestring
Comments

The expression may be inlined, or may be a reference to a named expression within a logic library referenced by the library element.

PlanDefinition.action.action
Definition

Sub actions that are contained within the action. The behavior of this action determines the functionality of the sub-actions. For example, a selection behavior of at-most-one indicates that of the sub-actions, at most one may be chosen as part of realizing the action definition.

Control0..*
TypeSee PlanDefinition.action