Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, Ineffective treatment frequency, Procedure-condition conflict, gaps in care, etc.

Business identifier associated with the detected issue record.

Allows linking instances of the same detected issue found on different servers.

Indicates the status of the detected issue.

This element is labeled as a modifier because the status contains the code entered-in-error that marks the issue as not currently valid.

A code that classifies the general type of detected issue.

Used for filtering what detected issues are retrieved and displayed.

In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

Identifies the specific type of issue identified.

Indicates the degree of importance associated with the identified issue based on the potential impact on the patient.

Indicates the subject whose record the detected issue is associated with.

While the subject could be inferred by tracing the subject of the implicated resources, it's useful to have a direct link for query purposes.

The encounter during which this issue was detected.

Links this detected issue to the Encounter context.

This will typically be the encounter the DetectedIssue was created during, but some DetectedIssues may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission lab tests).

The date or period when the detected issue was initially identified.

No-one can be responsible for mitigation prior to the issue being identified.

Individual or device responsible for the issue being raised. For example, a decision support application or a pharmacist conducting a medication review.

Indicates the resource representing the current activity or proposed activity that is potentially problematic.

There's an implicit constraint on the number of implicated resources based on DetectedIssue.type; e.g. For drug-drug, there would be more than one. For timing, there would typically only be one.

Supporting evidence or manifestations that provide the basis for identifying the detected issue such as a GuidanceResponse or MeasureReport.

A manifestation that led to the recording of this detected issue.

Links to resources that constitute evidence for the detected issue such as a GuidanceResponse or MeasureReport.

A textual explanation of the detected issue.

Should focus on information not covered elsewhere as discrete data - no need to duplicate the narrative.

The literature, knowledge-base or similar reference that describes the propensity for the detected issue identified.

Indicates an action that has been taken or is committed to reduce or eliminate the likelihood of the risk identified by the detected issue from manifesting. Can also reflect an observation of known mitigating factors that may reduce/eliminate the need for any action.

Describes the action that was taken or the observation that was made that reduces/eliminates the risk associated with the identified issue.

The "text" component can be used for detail or when no appropriate code exists.

Indicates when the mitigating action was documented.

This might not be the same as when the mitigating step was actually taken.

Identifies the practitioner who determined the mitigation and takes responsibility for the mitigation step occurring.

Clinicians may add additional notes or justifications about the mitigation action. For example, patient can have this drug because they have had it before without any issues. Multiple justifications may be provided.