Release 5 Ballot

This page is part of the FHIR Specification (v5.0.0-ballot: FHIR R5 Ballot Preview). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions

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

Definitions for the ebmrecommendation Profile.

ArtifactAssessment
Element IdArtifactAssessment
Definition

This Resource provides one or more comments, classifiers or ratings about a Resource and supports attribution and rights management metadata for the added content.

Short DisplayAdds metadata-supported comments, classifiers or ratings related to a Resource
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 in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').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.

ArtifactAssessment.id
Element IdArtifactAssessment.id
Definition

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

Short DisplayLogical id of this artifact
Cardinality0..1
Typeid
Comments

Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

ArtifactAssessment.meta
Element IdArtifactAssessment.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.

Short DisplayMetadata about 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())
ArtifactAssessment.implicitRules
Element IdArtifactAssessment.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.

Short DisplayA set of rules under which this content was created
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())
ArtifactAssessment.language
Element IdArtifactAssessment.language
Definition

The base language in which the resource is written.

Short DisplayLanguage of the resource content
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())
ArtifactAssessment.text
Element IdArtifactAssessment.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.

Short DisplayText summary of the resource, for human interpretation
Cardinality0..1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
Comments

Contained resources do not have a 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())
ArtifactAssessment.contained
Element IdArtifactAssessment.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

Short DisplayContained, inline Resources
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.

ArtifactAssessment.extension
Element IdArtifactAssessment.extension
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.

Short DisplayAdditional content defined by implementations
Cardinality0..*
TypeExtension
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()
ArtifactAssessment.modifierExtension
Element IdArtifactAssessment.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).

Short DisplayExtensions that cannot be ignored
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()
ArtifactAssessment.identifier
Element IdArtifactAssessment.identifier
Definition

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

Short DisplayAdditional identifier for the artifact assessment
Cardinality0..*
TypeIdentifier
Requirements

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

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.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
ArtifactAssessment.citeAs[x]
Element IdArtifactAssessment.citeAs[x]
Definition

Display of or reference to the bibliographic citation of the recommendation.

Short DisplayHow to cite the recommendation
Cardinality0..1
TypeChoice of: Reference(Citation), markdown
[x] NoteSee Choice of Datatypes 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
  • Open
  • discriminators: type:$this
ArtifactAssessment.date
Element IdArtifactAssessment.date
Definition

The date (and optionally time) when the artifact assessment was published. The date must change when the disposition changes and it must change if the workflow status code changes. In addition, it should change when the substantive content of the artifact assessment changes.

Short DisplayDate last changed
Cardinality0..1
TypedateTime
Alternate NamesRevision Date
Comments

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

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

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

Short DisplayUse and/or publishing restrictions
Cardinality0..1
Typemarkdown
Requirements

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

Alternate NamesLicense, Restrictions
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
ArtifactAssessment.approvalDate
Element IdArtifactAssessment.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.

Short DisplayWhen the artifact assessment was approved by publisher
Cardinality0..1
Typedate
Comments

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

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

Short DisplayWhen the artifact assessment was last reviewed
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.

Comments

If specified, this date follows the original approval date.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
ArtifactAssessment.artifact[x]
Element IdArtifactAssessment.artifact[x]
Definition

A reference to a resource, canonical resource, or non-FHIR resource which is the recommendation this comment or assessment is about.

Short DisplayThe artifact assessed, commented upon or rated
Cardinality1..1
TypeChoice of: Reference(PlanDefinition), canonical, uri
[x] NoteSee Choice of Datatypes for further information about how to use [x]
Must Supporttrue
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
  • Open
  • discriminators: type:$this
ArtifactAssessment.content
Element IdArtifactAssessment.content
Definition

A component comment, classifier, or rating of the artifact.

Short DisplayComment, classifier, or rating content
Cardinality0..*
TypeBackboneElement
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
ArtifactAssessment.content.id
Element IdArtifactAssessment.content.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short DisplayUnique id for inter-element referencing
Cardinality0..1
Typestring
ArtifactAssessment.content.extension
Element IdArtifactAssessment.content.extension
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.

Short DisplayAdditional content defined by implementations
Cardinality0..*
TypeExtension
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()
ArtifactAssessment.content.modifierExtension
Element IdArtifactAssessment.content.modifierExtension
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 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 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.

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

Short DisplayExtensions that cannot be ignored even if unrecognized
Cardinality0..*
TypeExtension
Is Modifiertrue (Reason: Modifier extensions are expected to modify the meaning or interpretation of the element 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, modifiers
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()
ArtifactAssessment.content.informationType
Element IdArtifactAssessment.content.informationType
Definition

The type of information this component of the content represents.

Short Displaycomment | classifier | rating | container | response | change-request
Cardinality0..1
Terminology Bindingnull
The codes SHALL be taken from Artifact Assessment Information Type
Typecode
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
ArtifactAssessment.content.summary
Element IdArtifactAssessment.content.summary
Definition

A brief summary of the content of this component.

Short DisplayBrief summary of the content
Cardinality0..1
Typemarkdown
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
ArtifactAssessment.content.type
Element IdArtifactAssessment.content.type
Definition

Indicates what type of content this component represents.

Short DisplayWhat type of content
Cardinality0..1
Terminology Bindingnull
For example codes, see EvidenceCertaintyType
TypeCodeableConcept
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
ArtifactAssessment.content.classifier
Element IdArtifactAssessment.content.classifier
Definition

Represents a rating, classifier, or assessment of the artifact.

Short DisplayRating, classifier, or assessment
Cardinality0..*
Terminology Bindingnull
For example codes, see EvidenceCertaintyRating
TypeCodeableConcept
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
ArtifactAssessment.content.author
Element IdArtifactAssessment.content.author
Definition

Indicates who or what authored the content.

Short DisplayWho authored the content
Cardinality0..1
TypeReference(Patient)
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
ArtifactAssessment.content.path
Element IdArtifactAssessment.content.path
Definition

A URI that points to what the comment is about, such as a line of text in the CQL, or a specific element in a resource.

Short DisplayWhat the comment is directed to
Cardinality0..*
Typeuri
Comments

The target element is used to point the comment to aspect of the artifact, such as a text range within a CQL library (e.g. #content?0:0-120:80).

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
ArtifactAssessment.content.relatedArtifact
Element IdArtifactAssessment.content.relatedArtifact
Definition

Additional related artifacts that provide supporting documentation, additional evidence, or further information related to the content.

Short DisplayAdditional information
Cardinality0..*
TypeRelatedArtifact
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
ArtifactAssessment.content.freeToShare
Element IdArtifactAssessment.content.freeToShare
Definition

Acceptable to publicly share the comment, classifier or rating.

Short DisplayAcceptable to publicly share the resource content
Cardinality0..1
Typeboolean
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
ArtifactAssessment.content.component
Element IdArtifactAssessment.content.component
Definition

If the informationType is container, the components of the content.

Short DisplayContained content
Cardinality0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.content
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
ArtifactAssessment.workflowStatus
Element IdArtifactAssessment.workflowStatus
Definition

Indicates the workflow status of the comment or change request.

Short Displaysubmitted | triaged | waiting-for-input | resolved-no-change | resolved-change-required | deferred | duplicate | applied | published
Cardinality0..0
Terminology Bindingnull
The codes SHALL be taken from Artifact Assessment Workflow Status
Typecode
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
ArtifactAssessment.disposition
Element IdArtifactAssessment.disposition
Definition

Indicates the disposition of the responsible party to the comment or change request.

Short Displayunresolved | not-persuasive | persuasive | persuasive-with-modification | not-persuasive-with-modification
Cardinality0..0
Terminology Bindingnull
The codes SHALL be taken from Artifact Assessment Disposition
Typecode
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())