Release 4B Snapshot #1

This page is part of the FHIR Specification v4.3.0-snapshot1: R4B Snapshot to support the Jan 2022 Connectathon. About the R4B version of FHIR. The current officially released version is 4.3.0. 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: 3 Trial UseSecurity Category: Anonymous Compartments: Not linked to any defined compartments

Detailed Descriptions for the elements in the ActivityDefinition resource.

ActivityDefinition
Element IdActivityDefinition
Definition

This resource allows for the definition of some activity to be performed, independent of a particular patient, practitioner, or other performance context.

Cardinality0..*
TypeDomainResource
Summaryfalse
Invariants
Defined on this element
cnl-0Warning Name should be usable as an identifier for the module by machine processing applications such as code generationname.matches('[A-Z]([A-Za-z0-9_]){0,254}')
ActivityDefinition.url
Element IdActivityDefinition.url
Definition

An absolute URI that is used to identify this activity definition when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this activity definition is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the activity definition is stored on different servers.

Cardinality0..1
Typeuri
Requirements

Allows the activity 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 determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in Technical and Business Versions.

In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the meta.source element to indicate where the current master source of the resource can be found.

ActivityDefinition.identifier
Element IdActivityDefinition.identifier
Definition

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

NoteThis is a business identifier, not a resource identifier (see discussion)
Cardinality0..*
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, and can then identify this activity definition outside of FHIR, where it is not possible to use the logical URI.

ActivityDefinition.version
Element IdActivityDefinition.version
Definition

The identifier that is used to identify this version of the activity definition when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the activity 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 assets.

NoteThis is a business versionId, not a resource version id (see discussion)
Cardinality0..1
Typestring
Summarytrue
Comments

There may be different activity 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 activity definition with the format [url]|[version].

ActivityDefinition.name
Element IdActivityDefinition.name
Definition

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

Cardinality0..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 alphanumeric type name to ensure that it is machine-processing friendly.

Invariants
Affect this element
cnl-0Warning Name should be usable as an identifier for the module by machine processing applications such as code generationname.matches('[A-Z]([A-Za-z0-9_]){0,254}')
ActivityDefinition.title
Element IdActivityDefinition.title
Definition

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

Cardinality0..1
Typestring
Summarytrue
Comments

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

ActivityDefinition.subtitle
Element IdActivityDefinition.subtitle
Definition

An explanatory or alternate title for the activity definition giving additional information about its content.

Cardinality0..1
Typestring
Summaryfalse
ActivityDefinition.status
Element IdActivityDefinition.status
Definition

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

Cardinality1..1
Terminology BindingPublicationStatus (Required)
Typecode
Is Modifiertrue (Reason: This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration)
Summarytrue
Comments

Allows filtering of activity definitions that are appropriate for use versus not.

ActivityDefinition.experimental
Element IdActivityDefinition.experimental
Definition

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

Cardinality0..1
Typeboolean
Requirements

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

Summarytrue
Comments

Allows filtering of activity definitions that are appropriate for use versus not.

ActivityDefinition.subject[x]
Element IdActivityDefinition.subject[x]
Definition

A code, group definition, or canonical reference that describes or identifies the intended subject of the activity being defined. Canonical references are allowed to support the definition of protocols for drug and substance quality specifications, and is allowed to reference a MedicinalProductDefinition, SubstanceDefinition, AdministrableProductDefinition, ManufacturedItemDefinition, or PackagedProductDefinition resource.

Cardinality0..1
Terminology BindingSubject type (Extensible)
TypeCodeableConcept|Reference(Group)|canonical
[x] NoteSee Choice of Data Types for further information about how to use [x]
Meaning if MissingPatient
Summaryfalse
ActivityDefinition.date
Element IdActivityDefinition.date
Definition

The date (and optionally time) when the activity definition was published. The date must change 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 activity definition changes.

Cardinality0..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 activity definition. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

ActivityDefinition.publisher
Element IdActivityDefinition.publisher
Definition

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

Cardinality0..1
Typestring
Requirements

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

Summarytrue
Comments

Usually an organization but may be an individual. The publisher (or steward) of the activity definition is the organization or individual primarily responsible for the maintenance and upkeep of the activity 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 activity definition. This item SHOULD be populated unless the information is available from context.

ActivityDefinition.contact
Element IdActivityDefinition.contact
Definition

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

Cardinality0..*
TypeContactDetail
Summarytrue
Comments

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

ActivityDefinition.description
Element IdActivityDefinition.description
Definition

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

Cardinality0..1
Typemarkdown
Summarytrue
Comments

This description can be used to capture details such as why the activity 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 activity 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 activity definition is presumed to be the predominant language in the place the activity definition was created).

ActivityDefinition.useContext
Element IdActivityDefinition.useContext
Definition

The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate activity definition instances.

Cardinality0..*
TypeUsageContext
Requirements

Assist in searching for appropriate content.

Summarytrue
Comments

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

ActivityDefinition.jurisdiction
Element IdActivityDefinition.jurisdiction
Definition

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

Cardinality0..*
Terminology BindingJurisdiction (Extensible)
TypeCodeableConcept
Summarytrue
Comments

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

ActivityDefinition.purpose
Element IdActivityDefinition.purpose
Definition

Explanation of why this activity definition is needed and why it has been designed as it has.

Cardinality0..1
Typemarkdown
Summaryfalse
Comments

This element does not describe the usage of the activity 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 activity definition.

ActivityDefinition.usage
Element IdActivityDefinition.usage
Definition

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

Cardinality0..1
Typestring
Summaryfalse
ActivityDefinition.copyright
Element IdActivityDefinition.copyright
Definition

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

Cardinality0..1
Typemarkdown
Requirements

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

Alternate NamesLicense; Restrictions
Summaryfalse
ActivityDefinition.approvalDate
Element IdActivityDefinition.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.

Cardinality0..1
Typedate
Summaryfalse
Comments

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

ActivityDefinition.lastReviewDate
Element IdActivityDefinition.lastReviewDate
Definition

The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.

Cardinality0..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.

Summaryfalse
Comments

If specified, this date follows the original approval date.

ActivityDefinition.effectivePeriod
Element IdActivityDefinition.effectivePeriod
Definition

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

Cardinality0..1
TypePeriod
Requirements

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

Summarytrue
Comments

The effective period for a activity 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.

ActivityDefinition.topic
Element IdActivityDefinition.topic
Definition

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

Cardinality0..*
Terminology BindingDefinitionTopic (Example)
TypeCodeableConcept
Requirements

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

Summaryfalse
ActivityDefinition.author
Element IdActivityDefinition.author
Definition

An individiual or organization primarily involved in the creation and maintenance of the content.

Cardinality0..*
TypeContactDetail
Summaryfalse
ActivityDefinition.editor
Element IdActivityDefinition.editor
Definition

An individual or organization primarily responsible for internal coherence of the content.

Cardinality0..*
TypeContactDetail
Summaryfalse
ActivityDefinition.reviewer
Element IdActivityDefinition.reviewer
Definition

An individual or organization primarily responsible for review of some aspect of the content.

Cardinality0..*
TypeContactDetail
Summaryfalse
ActivityDefinition.endorser
Element IdActivityDefinition.endorser
Definition

An individual or organization responsible for officially endorsing the content for use in some setting.

Cardinality0..*
TypeContactDetail
Summaryfalse
ActivityDefinition.relatedArtifact
Element IdActivityDefinition.relatedArtifact
Definition

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

Cardinality0..*
TypeRelatedArtifact
Requirements

Activity 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.

Summaryfalse
Comments

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

ActivityDefinition.library
Element IdActivityDefinition.library
Definition

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

Cardinality0..*
Typecanonical(Library)
Summaryfalse
ActivityDefinition.kind
Element IdActivityDefinition.kind
Definition

A description of the kind of resource the activity definition is representing. For example, a MedicationRequest, a ServiceRequest, or a CommunicationRequest. Typically, but not always, this is a Request resource.

Cardinality0..1
Terminology BindingRequestResourceType (Required)
Typecode
Summarytrue
Comments

May determine what types of extensions are permitted.

ActivityDefinition.profile
Element IdActivityDefinition.profile
Definition

A profile to which the target of the activity definition is expected to conform.

Cardinality0..1
Typecanonical(StructureDefinition)
Requirements

Allows profiles to be used to describe the types of activities that can be performed within a workflow, protocol, or order set.

Summaryfalse
ActivityDefinition.code
Element IdActivityDefinition.code
Definition

Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter.

Cardinality0..1
Terminology BindingProcedure Codes (SNOMED CT) (Example)
TypeCodeableConcept
Requirements

Allows matching performed to planned as well as validation against protocols.

Summarytrue
Comments

Tends to be less relevant for activities involving particular products.

ActivityDefinition.intent
Element IdActivityDefinition.intent
Definition

Indicates the level of authority/intentionality associated with the activity and where the request should fit into the workflow chain.

Cardinality0..1
Terminology BindingRequestIntent (Required)
Typecode
Summaryfalse
ActivityDefinition.priority
Element IdActivityDefinition.priority
Definition

Indicates how quickly the activity should be addressed with respect to other requests.

Cardinality0..1
Terminology BindingRequestPriority (Required)
Typecode
Summaryfalse
ActivityDefinition.doNotPerform
Element IdActivityDefinition.doNotPerform
Definition

Set this to true if the definition is to indicate that a particular activity should NOT be performed. If true, this element should be interpreted to reinforce a negative coding. For example NPO as a code with a doNotPerform of true would still indicate to NOT perform the action.

Cardinality0..1
Typeboolean
Is Modifiertrue (Reason: If true this element negates the specified action. For Example, instead of a request for a procedure, it is a request for the procedure to not occur.)
Summarytrue
Comments

This element is not intended to be used to communicate a decision support response to cancel an order in progress. That should be done with the "remove" type of a PlanDefinition or RequestGroup.

ActivityDefinition.timing[x]
Element IdActivityDefinition.timing[x]
Definition

The period, timing or frequency upon which the described activity is to occur.

Cardinality0..1
TypeTiming|dateTime|Age|Period|Range|Duration
[x] NoteSee Choice of Data Types for further information about how to use [x]
Requirements

Allows prompting for activities and detection of missed planned activities.

Summaryfalse
ActivityDefinition.location
Element IdActivityDefinition.location
Definition

Identifies the facility where the activity will occur; e.g. home, hospital, specific clinic, etc.

Cardinality0..1
TypeReference(Location)
Requirements

Helps in planning of activity.

Alternate Namesfacility
Summaryfalse
Comments

May reference a specific clinical location or may just identify a type of location.

ActivityDefinition.participant
Element IdActivityDefinition.participant
Definition

Indicates who should participate in performing the action described.

Cardinality0..*
Summaryfalse
ActivityDefinition.participant.type
Element IdActivityDefinition.participant.type
Definition

The type of participant in the action.

Cardinality1..1
Terminology BindingActionParticipantType (Required)
Typecode
Summaryfalse
ActivityDefinition.participant.role
Element IdActivityDefinition.participant.role
Definition

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

Cardinality0..1
Terminology BindingActionParticipantRole (Example)
TypeCodeableConcept
Summaryfalse
ActivityDefinition.product[x]
Element IdActivityDefinition.product[x]
Definition

Identifies the food, drug or other product being consumed or supplied in the activity.

Cardinality0..1
Terminology BindingSNOMED CT Medication Codes (Example)
TypeReference(Medication | Substance | Ingredient)|CodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
ActivityDefinition.quantity
Element IdActivityDefinition.quantity
Definition

Identifies the quantity expected to be consumed at once (per dose, per meal, etc.).

Cardinality0..1
TypeSimpleQuantity
Alternate Namesdose
Summaryfalse
ActivityDefinition.dosage
Element IdActivityDefinition.dosage
Definition

Provides detailed dosage instructions in the same way that they are described for MedicationRequest resources.

Cardinality0..*
TypeDosage
Summaryfalse
Comments

If a dosage instruction is used, the definition should not specify timing or quantity.

ActivityDefinition.bodySite
Element IdActivityDefinition.bodySite
Definition

Indicates the sites on the subject's body where the procedure should be performed (I.e. the target sites).

Cardinality0..*
Terminology BindingSNOMED CT Body Structures (Example)
TypeCodeableConcept
Requirements

Knowing where the procedure is made is important for tracking if multiple sites are possible.

Summaryfalse
Comments

Only used if not implicit in the code found in ServiceRequest.type.

ActivityDefinition.specimenRequirement
Element IdActivityDefinition.specimenRequirement
Definition

Defines specimen requirements for the action to be performed, such as required specimens for a lab test.

Cardinality0..*
TypeReference(SpecimenDefinition)
Requirements

Needed to represent lab order definitions.

Summaryfalse
ActivityDefinition.observationRequirement
Element IdActivityDefinition.observationRequirement
Definition

Defines observation requirements for the action to be performed, such as body weight or surface area.

Cardinality0..*
TypeReference(ObservationDefinition)
Requirements

Needed to represent observation definitions.

Summaryfalse
ActivityDefinition.observationResultRequirement
Element IdActivityDefinition.observationResultRequirement
Definition

Defines the observations that are expected to be produced by the action.

Cardinality0..*
TypeReference(ObservationDefinition)
Summaryfalse
ActivityDefinition.transform
Element IdActivityDefinition.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.

Cardinality0..1
Typecanonical(StructureMap)
Summaryfalse
Comments

Note that if both a transform and dynamic values are specified, the dynamic values will be applied to the result of the transform.

ActivityDefinition.dynamicValue
Element IdActivityDefinition.dynamicValue
Definition

Dynamic values that will be evaluated to produce values for elements of the resulting resource. For example, if the dosage of a medication must be computed based on the patient's weight, a dynamic value would be used to specify an expression that calculated the weight, and the path on the request resource that would contain the result.

Cardinality0..*
Summaryfalse
Comments

Dynamic values are applied in the order in which they are defined in the ActivityDefinition. Note that if both a transform and dynamic values are specified, the dynamic values will be applied to the result of the transform.

ActivityDefinition.dynamicValue.path
Element IdActivityDefinition.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. The specified path SHALL be a FHIRPath resolveable on the specified target type of the ActivityDefinition, and SHALL consist only of identifiers, constant indexers, and a restricted subset of functions. The path is allowed to contain qualifiers (.) to traverse sub-elements, as well as indexers ([x]) to traverse multiple-cardinality sub-elements (see the Simple FHIRPath Profile for full details).

Cardinality1..1
Typestring
Summaryfalse
Comments

The path attribute contains a Simple FHIRPath Subset that allows path traversal, but not calculation.

ActivityDefinition.dynamicValue.expression
Element IdActivityDefinition.dynamicValue.expression
Definition

An expression specifying the value of the customized element.

Cardinality1..1
TypeExpression
Summaryfalse
Comments

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