R4 Ballot #1 (Mixed Normative/Trial use)
Clinical SummaryThis page is part of the FHIR Specification (v3.3.0: R4 Ballot 2). 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 R2
| Clinical Decision Support Work Group | Maturity Level: N/A | Ballot Status: Informative | Compartments: Device, Patient, Practitioner |
StructureDefinition for riskassessment
{
"resourceType": "StructureDefinition",
"id": "RiskAssessment",
"meta": {
"lastUpdated": "2018-04-03T12:05:46.262+10:00"
},
"text": {
"status": "generated",
"div": "<div>!-- Snipped for Brevity --></div>"
},
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-ballot-status",
"valueString": "Trial Use"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger": 1
},
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode": "cds"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/RiskAssessment",
"name": "RiskAssessment",
"status": "draft",
"date": "2018-04-03T12:05:46+10:00",
"publisher": "Health Level Seven International (Clinical Decision Support)",
"contact": [
{
"telecom": [
{
"system": "url",
"value": "http://hl7.org/fhir"
}
]
},
{
"telecom": [
{
"system": "url",
"value": "http://www.hl7.org/Special/committees/dss/index.cfm"
}
]
}
],
"description": "An assessment of the likely outcome(s) for a patient or other subject as well as the likelihood of each outcome.",
"fhirVersion": "3.3.0",
"mapping": [
{
"identity": "workflow",
"uri": "http://hl7.org/fhir/workflow",
"name": "Workflow Pattern"
},
{
"identity": "v2",
"uri": "http://hl7.org/v2",
"name": "HL7 v2 Mapping"
},
{
"identity": "rim",
"uri": "http://hl7.org/v3",
"name": "RIM Mapping"
},
{
"identity": "openehr",
"uri": "http://openehr.org",
"name": "Open EHR Archetype Mapping"
},
{
"identity": "w5",
"uri": "http://hl7.org/fhir/fivews",
"name": "FiveWs Pattern"
}
],
"kind": "resource",
"abstract": false,
"type": "RiskAssessment",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"derivation": "specialization",
"snapshot": {
"element": [
{
"id": "RiskAssessment",
"path": "RiskAssessment",
"short": "Potential outcomes for a subject with likelihood",
"definition": "An assessment of the likely outcome(s) for a patient or other subject as well as the likelihood of each outcome.",
"alias": [
"Prognosis"
],
"min": 0,
"max": "*",
"base": {
"path": "RiskAssessment",
"min": 0,
"max": "*"
},
"constraint": [
{
"key": "dom-2",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"expression": "contained.contained.empty()",
"xpath": "not(parent::f:contained and f:contained)",
"source": "DomainResource"
},
{
"key": "dom-1",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL NOT contain any narrative",
"expression": "contained.text.empty()",
"xpath": "not(parent::f:contained and f:text)",
"source": "DomainResource"
},
{
"key": "dom-4",
"severity": "error",
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
"source": "DomainResource"
},
{
"key": "dom-3",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource",
"expression": "contained.all(('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists())",
"xpath": "not(exists(for $contained in f:contained return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
"source": "DomainResource"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "Entity. Role, or Act"
},
{
"identity": "workflow",
"map": "Event"
},
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "Observation[classCode=OBS, moodCode=EVN, code=\"Risk Assessment\"]"
},
{
"identity": "openehr",
"map": "OpenEHR-EHR-EVALUATION.risk.v1"
}
]
},
{
"id": "RiskAssessment.id",
"path": "RiskAssessment.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.",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "id"
}
],
"isModifier": false,
"isSummary": true
},
{
"id": "RiskAssessment.meta",
"path": "RiskAssessment.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 might not always be associated with version changes to the resource.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.meta",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Meta"
}
],
"isModifier": false,
"isSummary": true
},
{
"id": "RiskAssessment.implicitRules",
"path": "RiskAssessment.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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
"comment": "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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.implicitRules",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"isModifier": true,
"isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
"isSummary": true
},
{
"id": "RiskAssessment.language",
"path": "RiskAssessment.language",
"short": "Language of the resource content",
"definition": "The base language in which the resource is written.",
"comment": "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": "1"
},
"type": [
{
"code": "code"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueReference": {
"reference": "http://hl7.org/fhir/ValueSet/all-languages"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Language"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean": true
}
],
"strength": "extensible",
"description": "A human language.",
"valueSetCanonical": "http://hl7.org/fhir/ValueSet/languages"
}
},
{
"id": "RiskAssessment.text",
"path": "RiskAssessment.text",
"short": "Text summary of the resource, for human interpretation",
"definition": "A human-readable narrative that contains a summary of the resource and can 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.",
"comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
"alias": [
"narrative",
"html",
"xhtml",
"display"
],
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"dom-1"
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "Act.text?"
}
]
},
{
"id": "RiskAssessment.contained",
"path": "RiskAssessment.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.",
"comment": "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"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "RiskAssessment.extension",
"path": "RiskAssessment.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. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "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"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "RiskAssessment.modifierExtension",
"path": "RiskAssessment.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. 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.",
"comment": "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,
"isModifierReason": "Not known why this is labelled a modifier",
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "RiskAssessment.identifier",
"path": "RiskAssessment.identifier",
"short": "Unique identifier for the assessment",
"definition": "Business identifier assigned to the risk assessment.",
"min": 0,
"max": "*",
"base": {
"path": "RiskAssessment.identifier",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Identifier"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "workflow",
"map": "Event.identifier"
},
{
"identity": "w5",
"map": "FiveWs.identifier"
},
{
"identity": "rim",
"map": ".id"
},
{
"identity": "openehr",
"map": "Workflow Identifier"
}
]
},
{
"id": "RiskAssessment.basedOn",
"path": "RiskAssessment.basedOn",
"short": "Request fulfilled by this assessment",
"definition": "A reference to the request that is fulfilled by this risk assessment.",
"min": 0,
"max": "1",
"base": {
"path": "RiskAssessment.basedOn",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "workflow",
"map": "Event.basedOn"
}
]
},
{
"id": "RiskAssessment.parent",
"path": "RiskAssessment.parent",
"short": "Part of this occurrence",
"definition": "A reference to a resource that this risk assessment is part of, such as a Procedure.",
"min": 0,
"max": "1",
"base": {
"path": "RiskAssessment.parent",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "workflow",
"map": "Event.partOf"
}
]
},
{
"id": "RiskAssessment.status",
"path": "RiskAssessment.status",
"short": "registered | preliminary | final | amended +",
"definition": "The status of the RiskAssessment, using the same statuses as an Observation.",
"min": 1,
"max": "1",
"base": {
"path": "RiskAssessment.status",
"min": 1,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"isModifier": false,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "RiskAssessmentStatus"
}
],
"strength": "required",
"description": "The status of the risk assessment; e.g. preliminary, final, amended, etc.",
"valueSetCanonical": "http://hl7.org/fhir/ValueSet/observation-status"
},
"mapping": [
{
"identity": "workflow",
"map": "Event.status"
},
{
"identity": "w5",
"map": "FiveWs.status"
}
]
},
{
"id": "RiskAssessment.method",
"path": "RiskAssessment.method",
"short": "Evaluation mechanism",
"definition": "The algorithm, process or mechanism used to evaluate the risk.",
"requirements": "The method can influence the results of the assessment.",
"min": 0,
"max": "1",
"base": {
"path": "RiskAssessment.method",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"isModifier": false,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "RiskAssessmentMethod"
}
],
"strength": "example",
"description": "The mechanism or algorithm used to make the assessment; e.g. TIMI, PRISM, Cardiff Type 2 diabetes, etc."
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".methodCode"
}
]
},
{
"id": "RiskAssessment.code",
"path": "RiskAssessment.code",
"short": "Type of assessment",
"definition": "The type of the risk assessment performed.",
"min": 0,
"max": "1",
"base": {
"path": "RiskAssessment.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "workflow",
"map": "Event.code"
},
{
"identity": "w5",
"map": "FiveWs.what[x]"
}
]
},
{
"id": "RiskAssessment.subject",
"path": "RiskAssessment.subject",
"short": "Who/what does assessment apply to?",
"definition": "The patient or group the risk assessment applies to.",
"min": 1,
"max": "1",
"base": {
"path": "RiskAssessment.subject",
"min": 1,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/Group"
]
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "workflow",
"map": "Event.subject"
},
{
"identity": "w5",
"map": "FiveWs.subject[x]"
},
{
"identity": "rim",
"map": ".participation[typeCode=SBJ].role"
},
{
"identity": "openehr",
"map": "Subject of Care"
},
{
"identity": "w5",
"map": "FiveWs.subject"
}
]
},
{
"id": "RiskAssessment.context",
"path": "RiskAssessment.context",
"short": "Where was assessment performed?",
"definition": "The encounter where the assessment was performed.",
"min": 0,
"max": "1",
"base": {
"path": "RiskAssessment.context",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Encounter",
"http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
]
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "workflow",
"map": "Event.context"
},
{
"identity": "w5",
"map": "FiveWs.context"
},
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"
}
]
},
{
"id": "RiskAssessment.occurrence[x]",
"path": "RiskAssessment.occurrence[x]",
"short": "When was assessment made?",
"definition": "The date (and possibly time) the risk assessment was performed.",
"requirements": "The assessment results lose validity the more time elapses from when they are first made.",
"min": 0,
"max": "1",
"base": {
"path": "RiskAssessment.occurrence[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "dateTime"
},
{
"code": "Period"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "workflow",
"map": "Event.occurrence[x]"
},
{
"identity": "w5",
"map": "FiveWs.done[x]"
},
{
"identity": "rim",
"map": ".effectiveTime"
}
]
},
{
"id": "RiskAssessment.condition",
"path": "RiskAssessment.condition",
"short": "Condition assessed",
"definition": "For assessments or prognosis specific to a particular condition, indicates the condition being assessed.",
"min": 0,
"max": "1",
"base": {
"path": "RiskAssessment.condition",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Condition"
]
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN]"
}
]
},
{
"id": "RiskAssessment.performer",
"path": "RiskAssessment.performer",
"short": "Who did assessment?",
"definition": "The provider or software application that performed the assessment.",
"min": 0,
"max": "1",
"base": {
"path": "RiskAssessment.performer",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/Device"
]
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "workflow",
"map": "Event.performer.actor"
},
{
"identity": "w5",
"map": "FiveWs.actor"
},
{
"identity": "rim",
"map": ".participation[typeCode=PFM].role[classCode=ASSIGNED]"
},
{
"identity": "openehr",
"map": "Information Provider"
}
]
},
{
"id": "RiskAssessment.reasonCode",
"path": "RiskAssessment.reasonCode",
"short": "Why the assessment was necessary?",
"definition": "The reason the risk assessment was performed.",
"min": 0,
"max": "*",
"base": {
"path": "RiskAssessment.reasonCode",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "workflow",
"map": "Event.reasonCode"
},
{
"identity": "w5",
"map": "FiveWs.why[x]"
}
]
},
{
"id": "RiskAssessment.reasonReference",
"path": "RiskAssessment.reasonReference",
"short": "Why the assessment was necessary?",
"definition": "Resources supporting the reason the risk assessment was performed.",
"min": 0,
"max": "*",
"base": {
"path": "RiskAssessment.reasonReference",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Condition",
"http://hl7.org/fhir/StructureDefinition/Observation",
"http://hl7.org/fhir/StructureDefinition/DiagnosticReport",
"http://hl7.org/fhir/StructureDefinition/DocumentReference"
]
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "workflow",
"map": "Event.reasonReference"
},
{
"identity": "w5",
"map": "FiveWs.why[x]"
}
]
},
{
"id": "RiskAssessment.basis",
"path": "RiskAssessment.basis",
"short": "Information used in assessment",
"definition": "Indicates the source data considered as part of the assessment (for example, FamilyHistory, Observations, Procedures, Conditions, etc.).",
"min": 0,
"max": "*",
"base": {
"path": "RiskAssessment.basis",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=DRIV].target"
},
{
"identity": "openehr",
"map": "Risk Factor; Link to Evidence"
}
]
},
{
"id": "RiskAssessment.prediction",
"path": "RiskAssessment.prediction",
"short": "Outcome predicted",
"definition": "Describes the expected outcome for the subject.",
"comment": "Multiple repetitions can be used to identify the same type of outcome in different timeframes as well as different types of outcomes.",
"min": 0,
"max": "*",
"base": {
"path": "RiskAssessment.prediction",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() | (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "Element"
},
{
"key": "ras-2",
"severity": "error",
"human": "Must be <= 100",
"expression": "probability is decimal implies (probability as decimal) <= 100",
"xpath": "not(f:probabilityDecimal) or f:probabilityDecimal/@value <= 100"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=VALUE].target[classCod=OBS, moodCode=RISK]"
}
]
},
{
"id": "RiskAssessment.prediction.id",
"path": "RiskAssessment.prediction.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "RiskAssessment.prediction.extension",
"path": "RiskAssessment.prediction.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. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "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"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "RiskAssessment.prediction.modifierExtension",
"path": "RiskAssessment.prediction.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 in which it is contained. Usually modifier elements provide negation or qualification. 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 can 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.",
"comment": "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,
"isModifierReason": "modifierExtension is reserved for use where modifier extensions must be used",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "RiskAssessment.prediction.outcome",
"path": "RiskAssessment.prediction.outcome",
"short": "Possible outcome for the subject",
"definition": "One of the potential outcomes for the patient (e.g. remission, death, a particular condition).",
"min": 0,
"max": "1",
"base": {
"path": "RiskAssessment.prediction.outcome",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "RiskAssessmentOutcome"
}
],
"strength": "example",
"description": "The condition or other outcome; e.g. death, remission, amputation, infection, etc."
},
"mapping": [
{
"identity": "rim",
"map": ".value"
},
{
"identity": "openehr",
"map": "Risk"
}
]
},
{
"id": "RiskAssessment.prediction.probability[x]",
"path": "RiskAssessment.prediction.probability[x]",
"short": "Likelihood of specified outcome",
"definition": "Indicates how likely the outcome is (in the specified timeframe).",
"comment": "If range is used, it represents the lower and upper bounds of certainty; e.g. 40-60% Decimal values are expressed as percentages as well (max = 100).",
"min": 0,
"max": "1",
"base": {
"path": "RiskAssessment.prediction.probability[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "decimal"
},
{
"code": "Range"
}
],
"constraint": [
{
"key": "ras-1",
"severity": "error",
"human": "low and high must be percentages, if present",
"expression": "(low.empty() or ((low.code = '%') and (low.system = %ucum))) and (high.empty() or ((high.code = '%') and (high.system = %ucum)))",
"xpath": "(not(f:low) or f:low[f:code/@value='%' and f:system/@value='http://unitsofmeasure.org']) and (not(f:high) or f:high[f:code/@value='%' and f:system/@value='http://unitsofmeasure.org'])"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"probability\"].value"
},
{
"identity": "openehr",
"map": "Category"
}
]
},
{
"id": "RiskAssessment.prediction.qualitativeRisk",
"path": "RiskAssessment.prediction.qualitativeRisk",
"short": "Likelihood of specified outcome as a qualitative value",
"definition": "Indicates how likely the outcome is (in the specified timeframe), expressed as a qualitative value (e.g. low, medium, or high).",
"min": 0,
"max": "1",
"base": {
"path": "RiskAssessment.prediction.qualitativeRisk",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "RiskAssessmentProbability"
}
],
"strength": "example",
"description": "The likelihood of the occurrence of a specified outcome",
"valueSetCanonical": "http://hl7.org/fhir/ValueSet/risk-probability"
}
},
{
"id": "RiskAssessment.prediction.relativeRisk",
"path": "RiskAssessment.prediction.relativeRisk",
"short": "Relative likelihood",
"definition": "Indicates the risk for this particular subject (with their specific characteristics) divided by the risk of the population in general. (Numbers greater than 1 = higher risk than the population, numbers less than 1 = lower risk.).",
"requirements": "Absolute risk is less meaningful than relative risk.",
"min": 0,
"max": "1",
"base": {
"path": "RiskAssessment.prediction.relativeRisk",
"min": 0,
"max": "1"
},
"type": [
{
"code": "decimal"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"relative risk\"].value"
}
]
},
{
"id": "RiskAssessment.prediction.when[x]",
"path": "RiskAssessment.prediction.when[x]",
"short": "Timeframe or age range",
"definition": "Indicates the period of time or age range of the subject to which the specified probability applies.",
"comment": "If not specified, the risk applies \"over the subject's lifespan\".",
"min": 0,
"max": "1",
"base": {
"path": "RiskAssessment.prediction.when[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
},
{
"code": "Range"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".effectiveTime or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"age\"].value"
}
]
},
{
"id": "RiskAssessment.prediction.rationale",
"path": "RiskAssessment.prediction.rationale",
"short": "Explanation of prediction",
"definition": "Additional information explaining the basis for the prediction.",
"min": 0,
"max": "1",
"base": {
"path": "RiskAssessment.prediction.rationale",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".reasonCode.text"
},
{
"identity": "openehr",
"map": "Rationale"
}
]
},
{
"id": "RiskAssessment.mitigation",
"path": "RiskAssessment.mitigation",
"short": "How to reduce risk",
"definition": "A description of the steps that might be taken to reduce the identified risk(s).",
"requirements": "One of the main reasons for assessing risks is to identify whether interventional steps are needed to reduce risk.",
"min": 0,
"max": "1",
"base": {
"path": "RiskAssessment.mitigation",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=MTGT].target[classCode=ACT, moodCode=EVN].text"
}
]
},
{
"id": "RiskAssessment.note",
"path": "RiskAssessment.note",
"short": "Comments on the risk assessment",
"definition": "Additional comments about the risk assessment.",
"min": 0,
"max": "*",
"base": {
"path": "RiskAssessment.note",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Annotation"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "workflow",
"map": "Event.note"
}
]
}
]
},
"differential": {
"element": [
{
"id": "RiskAssessment",
"path": "RiskAssessment",
"short": "Potential outcomes for a subject with likelihood",
"definition": "An assessment of the likely outcome(s) for a patient or other subject as well as the likelihood of each outcome.",
"alias": [
"Prognosis"
],
"min": 0,
"max": "*",
"mapping": [
{
"identity": "workflow",
"map": "Event"
},
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "Observation[classCode=OBS, moodCode=EVN, code=\"Risk Assessment\"]"
},
{
"identity": "openehr",
"map": "OpenEHR-EHR-EVALUATION.risk.v1"
}
]
},
{
"id": "RiskAssessment.identifier",
"path": "RiskAssessment.identifier",
"short": "Unique identifier for the assessment",
"definition": "Business identifier assigned to the risk assessment.",
"min": 0,
"max": "*",
"type": [
{
"code": "Identifier"
}
],
"isSummary": true,
"mapping": [
{
"identity": "workflow",
"map": "Event.identifier"
},
{
"identity": "w5",
"map": "FiveWs.identifier"
},
{
"identity": "rim",
"map": ".id"
},
{
"identity": "openehr",
"map": "Workflow Identifier"
}
]
},
{
"id": "RiskAssessment.basedOn",
"path": "RiskAssessment.basedOn",
"short": "Request fulfilled by this assessment",
"definition": "A reference to the request that is fulfilled by this risk assessment.",
"min": 0,
"max": "1",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"mapping": [
{
"identity": "workflow",
"map": "Event.basedOn"
}
]
},
{
"id": "RiskAssessment.parent",
"path": "RiskAssessment.parent",
"short": "Part of this occurrence",
"definition": "A reference to a resource that this risk assessment is part of, such as a Procedure.",
"min": 0,
"max": "1",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"mapping": [
{
"identity": "workflow",
"map": "Event.partOf"
}
]
},
{
"id": "RiskAssessment.status",
"path": "RiskAssessment.status",
"short": "registered | preliminary | final | amended +",
"definition": "The status of the RiskAssessment, using the same statuses as an Observation.",
"min": 1,
"max": "1",
"type": [
{
"code": "code"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "RiskAssessmentStatus"
}
],
"strength": "required",
"description": "The status of the risk assessment; e.g. preliminary, final, amended, etc.",
"valueSetCanonical": "http://hl7.org/fhir/ValueSet/observation-status"
},
"mapping": [
{
"identity": "workflow",
"map": "Event.status"
},
{
"identity": "w5",
"map": "FiveWs.status"
}
]
},
{
"id": "RiskAssessment.method",
"path": "RiskAssessment.method",
"short": "Evaluation mechanism",
"definition": "The algorithm, process or mechanism used to evaluate the risk.",
"requirements": "The method can influence the results of the assessment.",
"min": 0,
"max": "1",
"type": [
{
"code": "CodeableConcept"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "RiskAssessmentMethod"
}
],
"strength": "example",
"description": "The mechanism or algorithm used to make the assessment; e.g. TIMI, PRISM, Cardiff Type 2 diabetes, etc."
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".methodCode"
}
]
},
{
"id": "RiskAssessment.code",
"path": "RiskAssessment.code",
"short": "Type of assessment",
"definition": "The type of the risk assessment performed.",
"min": 0,
"max": "1",
"type": [
{
"code": "CodeableConcept"
}
],
"isSummary": true,
"mapping": [
{
"identity": "workflow",
"map": "Event.code"
},
{
"identity": "w5",
"map": "FiveWs.what[x]"
}
]
},
{
"id": "RiskAssessment.subject",
"path": "RiskAssessment.subject",
"short": "Who/what does assessment apply to?",
"definition": "The patient or group the risk assessment applies to.",
"min": 1,
"max": "1",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/Group"
]
}
],
"isSummary": true,
"mapping": [
{
"identity": "workflow",
"map": "Event.subject"
},
{
"identity": "w5",
"map": "FiveWs.subject[x]"
},
{
"identity": "rim",
"map": ".participation[typeCode=SBJ].role"
},
{
"identity": "openehr",
"map": "Subject of Care"
},
{
"identity": "w5",
"map": "FiveWs.subject"
}
]
},
{
"id": "RiskAssessment.context",
"path": "RiskAssessment.context",
"short": "Where was assessment performed?",
"definition": "The encounter where the assessment was performed.",
"min": 0,
"max": "1",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Encounter",
"http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
]
}
],
"isSummary": true,
"mapping": [
{
"identity": "workflow",
"map": "Event.context"
},
{
"identity": "w5",
"map": "FiveWs.context"
},
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"
}
]
},
{
"id": "RiskAssessment.occurrence[x]",
"path": "RiskAssessment.occurrence[x]",
"short": "When was assessment made?",
"definition": "The date (and possibly time) the risk assessment was performed.",
"requirements": "The assessment results lose validity the more time elapses from when they are first made.",
"min": 0,
"max": "1",
"type": [
{
"code": "dateTime"
},
{
"code": "Period"
}
],
"isSummary": true,
"mapping": [
{
"identity": "workflow",
"map": "Event.occurrence[x]"
},
{
"identity": "w5",
"map": "FiveWs.done[x]"
},
{
"identity": "rim",
"map": ".effectiveTime"
}
]
},
{
"id": "RiskAssessment.condition",
"path": "RiskAssessment.condition",
"short": "Condition assessed",
"definition": "For assessments or prognosis specific to a particular condition, indicates the condition being assessed.",
"min": 0,
"max": "1",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Condition"
]
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN]"
}
]
},
{
"id": "RiskAssessment.performer",
"path": "RiskAssessment.performer",
"short": "Who did assessment?",
"definition": "The provider or software application that performed the assessment.",
"min": 0,
"max": "1",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/Device"
]
}
],
"isSummary": true,
"mapping": [
{
"identity": "workflow",
"map": "Event.performer.actor"
},
{
"identity": "w5",
"map": "FiveWs.actor"
},
{
"identity": "rim",
"map": ".participation[typeCode=PFM].role[classCode=ASSIGNED]"
},
{
"identity": "openehr",
"map": "Information Provider"
}
]
},
{
"id": "RiskAssessment.reasonCode",
"path": "RiskAssessment.reasonCode",
"short": "Why the assessment was necessary?",
"definition": "The reason the risk assessment was performed.",
"min": 0,
"max": "*",
"type": [
{
"code": "CodeableConcept"
}
],
"mapping": [
{
"identity": "workflow",
"map": "Event.reasonCode"
},
{
"identity": "w5",
"map": "FiveWs.why[x]"
}
]
},
{
"id": "RiskAssessment.reasonReference",
"path": "RiskAssessment.reasonReference",
"short": "Why the assessment was necessary?",
"definition": "Resources supporting the reason the risk assessment was performed.",
"min": 0,
"max": "*",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Condition",
"http://hl7.org/fhir/StructureDefinition/Observation",
"http://hl7.org/fhir/StructureDefinition/DiagnosticReport",
"http://hl7.org/fhir/StructureDefinition/DocumentReference"
]
}
],
"mapping": [
{
"identity": "workflow",
"map": "Event.reasonReference"
},
{
"identity": "w5",
"map": "FiveWs.why[x]"
}
]
},
{
"id": "RiskAssessment.basis",
"path": "RiskAssessment.basis",
"short": "Information used in assessment",
"definition": "Indicates the source data considered as part of the assessment (for example, FamilyHistory, Observations, Procedures, Conditions, etc.).",
"min": 0,
"max": "*",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=DRIV].target"
},
{
"identity": "openehr",
"map": "Risk Factor; Link to Evidence"
}
]
},
{
"id": "RiskAssessment.prediction",
"path": "RiskAssessment.prediction",
"short": "Outcome predicted",
"definition": "Describes the expected outcome for the subject.",
"comment": "Multiple repetitions can be used to identify the same type of outcome in different timeframes as well as different types of outcomes.",
"min": 0,
"max": "*",
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ras-2",
"severity": "error",
"human": "Must be <= 100",
"expression": "probability is decimal implies (probability as decimal) <= 100",
"xpath": "not(f:probabilityDecimal) or f:probabilityDecimal/@value <= 100"
}
],
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=VALUE].target[classCod=OBS, moodCode=RISK]"
}
]
},
{
"id": "RiskAssessment.prediction.outcome",
"path": "RiskAssessment.prediction.outcome",
"short": "Possible outcome for the subject",
"definition": "One of the potential outcomes for the patient (e.g. remission, death, a particular condition).",
"min": 0,
"max": "1",
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "RiskAssessmentOutcome"
}
],
"strength": "example",
"description": "The condition or other outcome; e.g. death, remission, amputation, infection, etc."
},
"mapping": [
{
"identity": "rim",
"map": ".value"
},
{
"identity": "openehr",
"map": "Risk"
}
]
},
{
"id": "RiskAssessment.prediction.probability[x]",
"path": "RiskAssessment.prediction.probability[x]",
"short": "Likelihood of specified outcome",
"definition": "Indicates how likely the outcome is (in the specified timeframe).",
"comment": "If range is used, it represents the lower and upper bounds of certainty; e.g. 40-60% Decimal values are expressed as percentages as well (max = 100).",
"min": 0,
"max": "1",
"type": [
{
"code": "decimal"
},
{
"code": "Range"
}
],
"constraint": [
{
"key": "ras-1",
"severity": "error",
"human": "low and high must be percentages, if present",
"expression": "(low.empty() or ((low.code = '%') and (low.system = %ucum))) and (high.empty() or ((high.code = '%') and (high.system = %ucum)))",
"xpath": "(not(f:low) or f:low[f:code/@value='%' and f:system/@value='http://unitsofmeasure.org']) and (not(f:high) or f:high[f:code/@value='%' and f:system/@value='http://unitsofmeasure.org'])"
}
],
"mapping": [
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"probability\"].value"
},
{
"identity": "openehr",
"map": "Category"
}
]
},
{
"id": "RiskAssessment.prediction.qualitativeRisk",
"path": "RiskAssessment.prediction.qualitativeRisk",
"short": "Likelihood of specified outcome as a qualitative value",
"definition": "Indicates how likely the outcome is (in the specified timeframe), expressed as a qualitative value (e.g. low, medium, or high).",
"min": 0,
"max": "1",
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "RiskAssessmentProbability"
}
],
"strength": "example",
"description": "The likelihood of the occurrence of a specified outcome",
"valueSetCanonical": "http://hl7.org/fhir/ValueSet/risk-probability"
}
},
{
"id": "RiskAssessment.prediction.relativeRisk",
"path": "RiskAssessment.prediction.relativeRisk",
"short": "Relative likelihood",
"definition": "Indicates the risk for this particular subject (with their specific characteristics) divided by the risk of the population in general. (Numbers greater than 1 = higher risk than the population, numbers less than 1 = lower risk.).",
"requirements": "Absolute risk is less meaningful than relative risk.",
"min": 0,
"max": "1",
"type": [
{
"code": "decimal"
}
],
"mapping": [
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"relative risk\"].value"
}
]
},
{
"id": "RiskAssessment.prediction.when[x]",
"path": "RiskAssessment.prediction.when[x]",
"short": "Timeframe or age range",
"definition": "Indicates the period of time or age range of the subject to which the specified probability applies.",
"comment": "If not specified, the risk applies \"over the subject's lifespan\".",
"min": 0,
"max": "1",
"type": [
{
"code": "Period"
},
{
"code": "Range"
}
],
"mapping": [
{
"identity": "rim",
"map": ".effectiveTime or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"age\"].value"
}
]
},
{
"id": "RiskAssessment.prediction.rationale",
"path": "RiskAssessment.prediction.rationale",
"short": "Explanation of prediction",
"definition": "Additional information explaining the basis for the prediction.",
"min": 0,
"max": "1",
"type": [
{
"code": "string"
}
],
"mapping": [
{
"identity": "rim",
"map": ".reasonCode.text"
},
{
"identity": "openehr",
"map": "Rationale"
}
]
},
{
"id": "RiskAssessment.mitigation",
"path": "RiskAssessment.mitigation",
"short": "How to reduce risk",
"definition": "A description of the steps that might be taken to reduce the identified risk(s).",
"requirements": "One of the main reasons for assessing risks is to identify whether interventional steps are needed to reduce risk.",
"min": 0,
"max": "1",
"type": [
{
"code": "string"
}
],
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=MTGT].target[classCode=ACT, moodCode=EVN].text"
}
]
},
{
"id": "RiskAssessment.note",
"path": "RiskAssessment.note",
"short": "Comments on the risk assessment",
"definition": "Additional comments about the risk assessment.",
"min": 0,
"max": "*",
"type": [
{
"code": "Annotation"
}
],
"mapping": [
{
"identity": "workflow",
"map": "Event.note"
}
]
}
]
}
}
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.
®© HL7.org 2011+. FHIR Mixed Nomative/Trial Use Ballot (v3.3.0-13671) generated on Tue, Apr 3, 2018 12:17+1000. QA Page
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