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

Clinical Decision Support Work Group Maturity Level: 0Trial Use Use Context: Any

Definitions for the cdshooksguidanceresponse Profile.

GuidanceResponse
Element IdGuidanceResponse
Definition

A guidance response is the formal response to a guidance request, including any output parameters returned by the evaluation, as well as the description of any proposed actions to be taken.

Cardinality1..1
Invariants
Inherited by this element
dom-2RuleIf the resource is contained in another resource, it SHALL NOT contain nested Resourcescontained.contained.empty()
dom-3RuleIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resourcecontained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4RuleIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdatedcontained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5RuleIf a resource is contained in another resource, it SHALL NOT have a security labelcontained.meta.security.empty()
dom-6GuidelineA resource should have narrative for robust managementtext.`div`.exists()
This is (only) a best practice guideline because:

When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.

GuidanceResponse.id
Element IdGuidanceResponse.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Cardinality0..1
Typeid
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

GuidanceResponse.meta
Element IdGuidanceResponse.meta
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.

Cardinality0..1
TypeMeta
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
GuidanceResponse.implicitRules
Element IdGuidanceResponse.implicitRules
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.

Cardinality0..1
Typeuri
Is Modifiertrue (Reason: 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)
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. 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.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
GuidanceResponse.language
Element IdGuidanceResponse.language
Definition

The base language in which the resource is written.

Cardinality0..1
Terminology BindingIETF language tag
The codes SHOULD be taken from Common Languages
Typecode
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
GuidanceResponse.text
Element IdGuidanceResponse.text
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.

Cardinality0..1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
Comments

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 information is added later.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
GuidanceResponse.contained
Element IdGuidanceResponse.contained
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.

Cardinality0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

GuidanceResponse.extension
Element IdGuidanceResponse.extension
Definition

An Extension

Cardinality0..*
TypeExtension
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
ext-1RuleMust have either extensions or value[x], not bothextension.exists() != value.exists()
SlicingThis element introduces a set of slices. The slicing rules are:
  • unordered
  • Open
  • discriminators: value:url
GuidanceResponse.extension(cdsHooksEndpoint)
Element IdGuidanceResponse.extension:cdsHooksEndpoint
Definition

Defines the service endpoint for the behavior implemented by the GuidanceResponse.

Cardinality1..1 This element is affected by the following invariants: ele-1
TypeExtension(cdsHooksEndpoint)
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or children unless an empty Parameters resourcehasValue() or (children().count() > id.count()) or $this is Parameters
ext-1RuleMust have either extensions or value[x], not bothextension.exists() != value.exists()
GuidanceResponse.modifierExtension
Element IdGuidanceResponse.modifierExtension
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 and/or the understanding of the containing element's descendants. 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality0..*
TypeExtension
Is Modifiertrue (Reason: Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them)
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions .

Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
ext-1RuleMust have either extensions or value[x], not bothextension.exists() != value.exists()
GuidanceResponse.requestIdentifier
Element IdGuidanceResponse.requestIdentifier
Definition

The identifier of the request associated with this response. If an identifier was given as part of the request, it will be reproduced here to enable the requester to more easily identify the response in a multi-request scenario.

Cardinality1..1
TypeIdentifier
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
GuidanceResponse.identifier
Element IdGuidanceResponse.identifier
Definition

Allows a service to provide unique, business identifiers for the response.

Cardinality1..1
TypeIdentifier
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
GuidanceResponse.module[x]
Element IdGuidanceResponse.module[x]
Definition

An identifier, CodeableConcept or canonical reference to the guidance that was requested.

Cardinality1..1
Typeuri
[x] NoteSee Choice of Data Types for further information about how to use [x]
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
SlicingThis element introduces a set of slices. The slicing rules are:
  • unordered
  • Closed
  • discriminators: type:$this
GuidanceResponse.module[x](moduleUri)
Element IdGuidanceResponse.module[x]:moduleUri
Definition

An identifier, CodeableConcept or canonical reference to the guidance that was requested.

Cardinality1..1
Typeuri
[x] NoteSee Choice of Data Types for further information about how to use [x]
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
GuidanceResponse.status
Element IdGuidanceResponse.status
Definition

The status of the response. If the evaluation is completed successfully, the status will indicate success. However, in order to complete the evaluation, the engine may require more information. In this case, the status will be data-required, and the response will contain a description of the additional required information. If the evaluation completed successfully, but the engine determines that a potentially more accurate response could be provided if more data was available, the status will be data-requested, and the response will contain a description of the additional requested information.

Cardinality1..1
Terminology BindingThe status of a guidance response.
The codes SHALL be taken from GuidanceResponseStatus
Typecode
Is Modifiertrue (Reason: This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid)
Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
GuidanceResponse.subject
Element IdGuidanceResponse.subject
Definition

The patient for which the request was processed.

Cardinality0..1
TypeReference(Patient)
Must Supporttrue
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
GuidanceResponse.encounter
Element IdGuidanceResponse.encounter
Definition

The encounter during which this response was created or to which the creation of this record is tightly associated.

Cardinality0..1
TypeReference(Encounter)
Comments

This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official copmletion of an encounter but still be tied to the context of the encounter.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
GuidanceResponse.occurrenceDateTime
Element IdGuidanceResponse.occurrenceDateTime
Definition

Indicates when the guidance response was processed.

Cardinality0..1
TypedateTime
Must Supporttrue
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
GuidanceResponse.performer
Element IdGuidanceResponse.performer
Definition

Provides a reference to the device that performed the guidance.

Cardinality0..1
TypeReference(Device)
Must Supporttrue
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
GuidanceResponse.reasonCode
Element IdGuidanceResponse.reasonCode
Definition

Describes the reason for the guidance response in coded or textual form.

Cardinality0..*
TypeCodeableConcept
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
GuidanceResponse.reasonReference
Element IdGuidanceResponse.reasonReference
Definition

Indicates the reason the request was initiated. This is typically provided as a parameter to the evaluation and echoed by the service, although for some use cases, such as subscription- or event-based scenarios, it may provide an indication of the cause for the response.

Cardinality0..*
TypeReference(Condition)
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
GuidanceResponse.note
Element IdGuidanceResponse.note
Definition

Provides a mechanism to communicate additional information about the response.

Cardinality0..*
TypeAnnotation
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
GuidanceResponse.evaluationMessage
Element IdGuidanceResponse.evaluationMessage
Definition

Messages resulting from the evaluation of the artifact or artifacts. As part of evaluating the request, the engine may produce informational or warning messages. These messages will be provided by this element.

Cardinality0..*
TypeReference(OperationOutcome)
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
GuidanceResponse.outputParameters
Element IdGuidanceResponse.outputParameters
Definition

The output parameters of the evaluation, if any. Many modules will result in the return of specific resources such as procedure or communication requests that are returned as part of the operation result. However, modules may define specific outputs that would be returned as the result of the evaluation, and these would be returned in this element.

Cardinality0..1
TypeReference(Parameters)
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
GuidanceResponse.result
Element IdGuidanceResponse.result
Definition

The actions, if any, produced by the evaluation of the artifact.

Cardinality0..1
TypeReference(CarePlan)
Must Supporttrue
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
GuidanceResponse.dataRequirement
Element IdGuidanceResponse.dataRequirement
Definition

If the evaluation could not be completed due to lack of information, or additional information would potentially result in a more accurate response, this element will a description of the data required in order to proceed with the evaluation. A subsequent request to the service should include this data.

Cardinality0..*
TypeDataRequirement
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())