Release 4

This page is part of the FHIR Specification (v4.0.1: R4 - Mixed Normative and STU) in it's permanent home (it will always be available at this URL). 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

9.11 Resource RiskAssessment - Content

Clinical Decision Support Work GroupMaturity Level: 1 Trial UseSecurity Category: Patient Compartments: Device, Patient, Practitioner

An assessment of the likely outcome(s) for a patient or other subject as well as the likelihood of each outcome.

9.11.1 Scope and Usage

This resource is an event resource from a FHIR workflow perspective - see Workflow, specifically Event.

This resource captures predicted outcomes for a patient or population on the basis of source information. Examples include:

  • A prognosis statement for a particular condition
  • Risk of health outcome (heart attack, particular type of cancer) on the basis of lifestyle factors and/or family history
  • List of potential health risks based on a patient's genetic analysis
  • A prediction of outbreak infection rates within a geography based on immunization rates

This resource can be used to represent the results of formal scoring/decision support tools that evaluate risk. It can also be used to capture a practitioner's subjective assessment of the patient's risk based on existing knowledge and previous experience.

9.11.2 Boundaries and Relationships

Risk assessments are a specialized type of observation. A specialized resource is used to provide a simpler mechanism to capture of a series of risks and to associate those risks with time-ranges, probabilities, etc. All risk assertions are captured at one time based on a single set of source inputs. Capture of a single risk MAY be done using the Observation class, particularly in circumstances where it's treated as a generic observation, but for consistency, all risk assessments and prognosis SHOULD be captured using RiskAssessment.

Risk assessments may be based on a variety of factors, including:

Because so many resources can potentially be used, no limit is placed on what resources can be sent in RiskAssessment.basis. However, some resources would be nonsensical for this use (e.g. MessageHeader).

AllergyIntolerance and RiskAssessment

AllergyIntolerance describes a specific type of risk - propensity to reaction to a substance while RiskAssessment describes general risks to a subject, not generally based on a reaction.

9.11.3 Background and Context

Risk Assessments can be determined manually by health-care providers based on their professional expertise, by using an algorithmic scoring system or through a combination. Risk assessments can also be computed by decision support systems. OperationDefinitions may be defined by servers to generate risk assessments based on particular combinations of source resources or other inputs.

This resource is referenced by ClinicalImpression and Goal

9.11.4 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. RiskAssessment TUDomainResourcePotential outcomes for a subject with likelihood
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierUnique identifier for the assessment
... basedOn 0..1Reference(Any)Request fulfilled by this assessment
... parent 0..1Reference(Any)Part of this occurrence
... status Σ1..1coderegistered | preliminary | final | amended +
ObservationStatus (Required)
... method Σ0..1CodeableConceptEvaluation mechanism
... code Σ0..1CodeableConceptType of assessment
... subject Σ1..1Reference(Patient | Group)Who/what does assessment apply to?
... encounter Σ0..1Reference(Encounter)Where was assessment performed?
... occurrence[x] Σ0..1When was assessment made?
.... occurrenceDateTimedateTime
.... occurrencePeriodPeriod
... condition Σ0..1Reference(Condition)Condition assessed
... performer Σ0..1Reference(Practitioner | PractitionerRole | Device)Who did assessment?
... reasonCode 0..*CodeableConceptWhy the assessment was necessary?
... reasonReference 0..*Reference(Condition | Observation | DiagnosticReport | DocumentReference)Why the assessment was necessary?
... basis 0..*Reference(Any)Information used in assessment
... prediction I0..*BackboneElementOutcome predicted
+ Rule: Must be <= 100
.... outcome 0..1CodeableConceptPossible outcome for the subject
.... probability[x] I0..1Likelihood of specified outcome
+ Rule: low and high must be percentages, if present
..... probabilityDecimaldecimal
..... probabilityRangeRange
.... qualitativeRisk 0..1CodeableConceptLikelihood of specified outcome as a qualitative value
Risk Probability (Example)
.... relativeRisk 0..1decimalRelative likelihood
.... when[x] 0..1Timeframe or age range
..... whenPeriodPeriod
..... whenRangeRange
.... rationale 0..1stringExplanation of prediction
... mitigation 0..1stringHow to reduce risk
... note 0..*AnnotationComments on the risk assessment

doco Documentation for this format

UML Diagram (Legend)

RiskAssessment (DomainResource)Business identifier assigned to the risk assessmentidentifier : Identifier [0..*]A reference to the request that is fulfilled by this risk assessmentbasedOn : Reference [0..1] « Any »A reference to a resource that this risk assessment is part of, such as a Procedureparent : Reference [0..1] « Any »The status of the RiskAssessment, using the same statuses as an Observationstatus : code [1..1] « The status of the risk assessment; e.g. preliminary, final, amended, etc. (Strength=Required)ObservationStatus! »The algorithm, process or mechanism used to evaluate the riskmethod : CodeableConcept [0..1]The type of the risk assessment performedcode : CodeableConcept [0..1]The patient or group the risk assessment applies tosubject : Reference [1..1] « Patient|Group »The encounter where the assessment was performedencounter : Reference [0..1] « Encounter »The date (and possibly time) the risk assessment was performedoccurrence[x] : Type [0..1] « dateTime|Period »For assessments or prognosis specific to a particular condition, indicates the condition being assessedcondition : Reference [0..1] « Condition »The provider or software application that performed the assessmentperformer : Reference [0..1] « Practitioner|PractitionerRole|Device »The reason the risk assessment was performedreasonCode : CodeableConcept [0..*]Resources supporting the reason the risk assessment was performedreasonReference : Reference [0..*] « Condition|Observation| DiagnosticReport|DocumentReference »Indicates the source data considered as part of the assessment (for example, FamilyHistory, Observations, Procedures, Conditions, etc.)basis : Reference [0..*] « Any »A description of the steps that might be taken to reduce the identified risk(s)mitigation : string [0..1]Additional comments about the risk assessmentnote : Annotation [0..*]PredictionOne of the potential outcomes for the patient (e.g. remission, death, a particular condition)outcome : CodeableConcept [0..1]Indicates how likely the outcome is (in the specified timeframe)probability[x] : Type [0..1] « decimal|Range »Indicates how likely the outcome is (in the specified timeframe), expressed as a qualitative value (e.g. low, medium, or high)qualitativeRisk : CodeableConcept [0..1] « The likelihood of the occurrence of a specified outcome. (Strength=Example)RiskProbability?? »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.)relativeRisk : decimal [0..1]Indicates the period of time or age range of the subject to which the specified probability applieswhen[x] : Type [0..1] « Period|Range »Additional information explaining the basis for the predictionrationale : string [0..1]Describes the expected outcome for the subjectprediction[0..*]

XML Template

<RiskAssessment xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Unique identifier for the assessment --></identifier>
 <basedOn><!-- 0..1 Reference(Any) Request fulfilled by this assessment --></basedOn>
 <parent><!-- 0..1 Reference(Any) Part of this occurrence --></parent>
 <status value="[code]"/><!-- 1..1 registered | preliminary | final | amended + -->
 <method><!-- 0..1 CodeableConcept Evaluation mechanism --></method>
 <code><!-- 0..1 CodeableConcept Type of assessment --></code>
 <subject><!-- 1..1 Reference(Patient|Group) Who/what does assessment apply to? --></subject>
 <encounter><!-- 0..1 Reference(Encounter) Where was assessment performed? --></encounter>
 <occurrence[x]><!-- 0..1 dateTime|Period When was assessment made? --></occurrence[x]>
 <condition><!-- 0..1 Reference(Condition) Condition assessed --></condition>
 <performer><!-- 0..1 Reference(Practitioner|PractitionerRole|Device) Who did assessment? --></performer>
 <reasonCode><!-- 0..* CodeableConcept Why the assessment was necessary? --></reasonCode>
 <reasonReference><!-- 0..* Reference(Condition|Observation|DiagnosticReport|
   DocumentReference) Why the assessment was necessary? --></reasonReference>
 <basis><!-- 0..* Reference(Any) Information used in assessment --></basis>
 <prediction>  <!-- 0..* Outcome predicted -->
  <outcome><!-- 0..1 CodeableConcept Possible outcome for the subject --></outcome>
  <probability[x]><!-- 0..1 decimal|Range Likelihood of specified outcome --></probability[x]>
  <qualitativeRisk><!-- 0..1 CodeableConcept Likelihood of specified outcome as a qualitative value --></qualitativeRisk>
  <relativeRisk value="[decimal]"/><!-- 0..1 Relative likelihood -->
  <when[x]><!-- 0..1 Period|Range Timeframe or age range --></when[x]>
  <rationale value="[string]"/><!-- 0..1 Explanation of prediction -->
 </prediction>
 <mitigation value="[string]"/><!-- 0..1 How to reduce risk -->
 <note><!-- 0..* Annotation Comments on the risk assessment --></note>
</RiskAssessment>

JSON Template

{doco
  "resourceType" : "RiskAssessment",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Unique identifier for the assessment
  "basedOn" : { Reference(Any) }, // Request fulfilled by this assessment
  "parent" : { Reference(Any) }, // Part of this occurrence
  "status" : "<code>", // R!  registered | preliminary | final | amended +
  "method" : { CodeableConcept }, // Evaluation mechanism
  "code" : { CodeableConcept }, // Type of assessment
  "subject" : { Reference(Patient|Group) }, // R!  Who/what does assessment apply to?
  "encounter" : { Reference(Encounter) }, // Where was assessment performed?
  // occurrence[x]: When was assessment made?. One of these 2:
  "occurrenceDateTime" : "<dateTime>",
  "occurrencePeriod" : { Period },
  "condition" : { Reference(Condition) }, // Condition assessed
  "performer" : { Reference(Practitioner|PractitionerRole|Device) }, // Who did assessment?
  "reasonCode" : [{ CodeableConcept }], // Why the assessment was necessary?
  "reasonReference" : [{ Reference(Condition|Observation|DiagnosticReport|
   DocumentReference) }], // Why the assessment was necessary?
  "basis" : [{ Reference(Any) }], // Information used in assessment
  "prediction" : [{ // Outcome predicted
    "outcome" : { CodeableConcept }, // Possible outcome for the subject
    // probability[x]: Likelihood of specified outcome. One of these 2:
    "probabilityDecimal" : <decimal>,
    "probabilityRange" : { Range },
    "qualitativeRisk" : { CodeableConcept }, // Likelihood of specified outcome as a qualitative value
    "relativeRisk" : <decimal>, // Relative likelihood
    // when[x]: Timeframe or age range. One of these 2:
    "whenPeriod" : { Period },
    "whenRange" : { Range },
    "rationale" : "<string>" // Explanation of prediction
  }],
  "mitigation" : "<string>", // How to reduce risk
  "note" : [{ Annotation }] // Comments on the risk assessment
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:RiskAssessment;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:RiskAssessment.identifier [ Identifier ], ... ; # 0..* Unique identifier for the assessment
  fhir:RiskAssessment.basedOn [ Reference(Any) ]; # 0..1 Request fulfilled by this assessment
  fhir:RiskAssessment.parent [ Reference(Any) ]; # 0..1 Part of this occurrence
  fhir:RiskAssessment.status [ code ]; # 1..1 registered | preliminary | final | amended +
  fhir:RiskAssessment.method [ CodeableConcept ]; # 0..1 Evaluation mechanism
  fhir:RiskAssessment.code [ CodeableConcept ]; # 0..1 Type of assessment
  fhir:RiskAssessment.subject [ Reference(Patient|Group) ]; # 1..1 Who/what does assessment apply to?
  fhir:RiskAssessment.encounter [ Reference(Encounter) ]; # 0..1 Where was assessment performed?
  # RiskAssessment.occurrence[x] : 0..1 When was assessment made?. One of these 2
    fhir:RiskAssessment.occurrenceDateTime [ dateTime ]
    fhir:RiskAssessment.occurrencePeriod [ Period ]
  fhir:RiskAssessment.condition [ Reference(Condition) ]; # 0..1 Condition assessed
  fhir:RiskAssessment.performer [ Reference(Practitioner|PractitionerRole|Device) ]; # 0..1 Who did assessment?
  fhir:RiskAssessment.reasonCode [ CodeableConcept ], ... ; # 0..* Why the assessment was necessary?
  fhir:RiskAssessment.reasonReference [ Reference(Condition|Observation|DiagnosticReport|DocumentReference) ], ... ; # 0..* Why the assessment was necessary?
  fhir:RiskAssessment.basis [ Reference(Any) ], ... ; # 0..* Information used in assessment
  fhir:RiskAssessment.prediction [ # 0..* Outcome predicted
    fhir:RiskAssessment.prediction.outcome [ CodeableConcept ]; # 0..1 Possible outcome for the subject
    # RiskAssessment.prediction.probability[x] : 0..1 Likelihood of specified outcome. One of these 2
      fhir:RiskAssessment.prediction.probabilityDecimal [ decimal ]
      fhir:RiskAssessment.prediction.probabilityRange [ Range ]
    fhir:RiskAssessment.prediction.qualitativeRisk [ CodeableConcept ]; # 0..1 Likelihood of specified outcome as a qualitative value
    fhir:RiskAssessment.prediction.relativeRisk [ decimal ]; # 0..1 Relative likelihood
    # RiskAssessment.prediction.when[x] : 0..1 Timeframe or age range. One of these 2
      fhir:RiskAssessment.prediction.whenPeriod [ Period ]
      fhir:RiskAssessment.prediction.whenRange [ Range ]
    fhir:RiskAssessment.prediction.rationale [ string ]; # 0..1 Explanation of prediction
  ], ...;
  fhir:RiskAssessment.mitigation [ string ]; # 0..1 How to reduce risk
  fhir:RiskAssessment.note [ Annotation ], ... ; # 0..* Comments on the risk assessment
]

Changes since R3

RiskAssessment
RiskAssessment.identifier
  • Max Cardinality changed from 1 to *
RiskAssessment.status
  • Change value set from http://hl7.org/fhir/ValueSet/observation-status to http://hl7.org/fhir/ValueSet/observation-status|4.0.1
RiskAssessment.subject
  • Min Cardinality changed from 0 to 1
RiskAssessment.encounter
  • Added Element
RiskAssessment.performer
  • Type Reference: Added Target Type PractitionerRole
RiskAssessment.reasonCode
  • Added Element
RiskAssessment.reasonReference
  • Added Element
RiskAssessment.prediction.outcome
  • Min Cardinality changed from 1 to 0
RiskAssessment.note
  • Renamed from comment to note
  • Max Cardinality changed from 1 to *
  • Type changed from string to Annotation
RiskAssessment.context
  • deleted
RiskAssessment.reason[x]
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 4 tests that all execute ok. All tests pass round-trip testing and 3 r3 resources are invalid (0 errors).)

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. RiskAssessment TUDomainResourcePotential outcomes for a subject with likelihood
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierUnique identifier for the assessment
... basedOn 0..1Reference(Any)Request fulfilled by this assessment
... parent 0..1Reference(Any)Part of this occurrence
... status Σ1..1coderegistered | preliminary | final | amended +
ObservationStatus (Required)
... method Σ0..1CodeableConceptEvaluation mechanism
... code Σ0..1CodeableConceptType of assessment
... subject Σ1..1Reference(Patient | Group)Who/what does assessment apply to?
... encounter Σ0..1Reference(Encounter)Where was assessment performed?
... occurrence[x] Σ0..1When was assessment made?
.... occurrenceDateTimedateTime
.... occurrencePeriodPeriod
... condition Σ0..1Reference(Condition)Condition assessed
... performer Σ0..1Reference(Practitioner | PractitionerRole | Device)Who did assessment?
... reasonCode 0..*CodeableConceptWhy the assessment was necessary?
... reasonReference 0..*Reference(Condition | Observation | DiagnosticReport | DocumentReference)Why the assessment was necessary?
... basis 0..*Reference(Any)Information used in assessment
... prediction I0..*BackboneElementOutcome predicted
+ Rule: Must be <= 100
.... outcome 0..1CodeableConceptPossible outcome for the subject
.... probability[x] I0..1Likelihood of specified outcome
+ Rule: low and high must be percentages, if present
..... probabilityDecimaldecimal
..... probabilityRangeRange
.... qualitativeRisk 0..1CodeableConceptLikelihood of specified outcome as a qualitative value
Risk Probability (Example)
.... relativeRisk 0..1decimalRelative likelihood
.... when[x] 0..1Timeframe or age range
..... whenPeriodPeriod
..... whenRangeRange
.... rationale 0..1stringExplanation of prediction
... mitigation 0..1stringHow to reduce risk
... note 0..*AnnotationComments on the risk assessment

doco Documentation for this format

UML Diagram (Legend)

RiskAssessment (DomainResource)Business identifier assigned to the risk assessmentidentifier : Identifier [0..*]A reference to the request that is fulfilled by this risk assessmentbasedOn : Reference [0..1] « Any »A reference to a resource that this risk assessment is part of, such as a Procedureparent : Reference [0..1] « Any »The status of the RiskAssessment, using the same statuses as an Observationstatus : code [1..1] « The status of the risk assessment; e.g. preliminary, final, amended, etc. (Strength=Required)ObservationStatus! »The algorithm, process or mechanism used to evaluate the riskmethod : CodeableConcept [0..1]The type of the risk assessment performedcode : CodeableConcept [0..1]The patient or group the risk assessment applies tosubject : Reference [1..1] « Patient|Group »The encounter where the assessment was performedencounter : Reference [0..1] « Encounter »The date (and possibly time) the risk assessment was performedoccurrence[x] : Type [0..1] « dateTime|Period »For assessments or prognosis specific to a particular condition, indicates the condition being assessedcondition : Reference [0..1] « Condition »The provider or software application that performed the assessmentperformer : Reference [0..1] « Practitioner|PractitionerRole|Device »The reason the risk assessment was performedreasonCode : CodeableConcept [0..*]Resources supporting the reason the risk assessment was performedreasonReference : Reference [0..*] « Condition|Observation| DiagnosticReport|DocumentReference »Indicates the source data considered as part of the assessment (for example, FamilyHistory, Observations, Procedures, Conditions, etc.)basis : Reference [0..*] « Any »A description of the steps that might be taken to reduce the identified risk(s)mitigation : string [0..1]Additional comments about the risk assessmentnote : Annotation [0..*]PredictionOne of the potential outcomes for the patient (e.g. remission, death, a particular condition)outcome : CodeableConcept [0..1]Indicates how likely the outcome is (in the specified timeframe)probability[x] : Type [0..1] « decimal|Range »Indicates how likely the outcome is (in the specified timeframe), expressed as a qualitative value (e.g. low, medium, or high)qualitativeRisk : CodeableConcept [0..1] « The likelihood of the occurrence of a specified outcome. (Strength=Example)RiskProbability?? »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.)relativeRisk : decimal [0..1]Indicates the period of time or age range of the subject to which the specified probability applieswhen[x] : Type [0..1] « Period|Range »Additional information explaining the basis for the predictionrationale : string [0..1]Describes the expected outcome for the subjectprediction[0..*]

XML Template

<RiskAssessment xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Unique identifier for the assessment --></identifier>
 <basedOn><!-- 0..1 Reference(Any) Request fulfilled by this assessment --></basedOn>
 <parent><!-- 0..1 Reference(Any) Part of this occurrence --></parent>
 <status value="[code]"/><!-- 1..1 registered | preliminary | final | amended + -->
 <method><!-- 0..1 CodeableConcept Evaluation mechanism --></method>
 <code><!-- 0..1 CodeableConcept Type of assessment --></code>
 <subject><!-- 1..1 Reference(Patient|Group) Who/what does assessment apply to? --></subject>
 <encounter><!-- 0..1 Reference(Encounter) Where was assessment performed? --></encounter>
 <occurrence[x]><!-- 0..1 dateTime|Period When was assessment made? --></occurrence[x]>
 <condition><!-- 0..1 Reference(Condition) Condition assessed --></condition>
 <performer><!-- 0..1 Reference(Practitioner|PractitionerRole|Device) Who did assessment? --></performer>
 <reasonCode><!-- 0..* CodeableConcept Why the assessment was necessary? --></reasonCode>
 <reasonReference><!-- 0..* Reference(Condition|Observation|DiagnosticReport|
   DocumentReference) Why the assessment was necessary? --></reasonReference>
 <basis><!-- 0..* Reference(Any) Information used in assessment --></basis>
 <prediction>  <!-- 0..* Outcome predicted -->
  <outcome><!-- 0..1 CodeableConcept Possible outcome for the subject --></outcome>
  <probability[x]><!-- 0..1 decimal|Range Likelihood of specified outcome --></probability[x]>
  <qualitativeRisk><!-- 0..1 CodeableConcept Likelihood of specified outcome as a qualitative value --></qualitativeRisk>
  <relativeRisk value="[decimal]"/><!-- 0..1 Relative likelihood -->
  <when[x]><!-- 0..1 Period|Range Timeframe or age range --></when[x]>
  <rationale value="[string]"/><!-- 0..1 Explanation of prediction -->
 </prediction>
 <mitigation value="[string]"/><!-- 0..1 How to reduce risk -->
 <note><!-- 0..* Annotation Comments on the risk assessment --></note>
</RiskAssessment>

JSON Template

{doco
  "resourceType" : "RiskAssessment",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Unique identifier for the assessment
  "basedOn" : { Reference(Any) }, // Request fulfilled by this assessment
  "parent" : { Reference(Any) }, // Part of this occurrence
  "status" : "<code>", // R!  registered | preliminary | final | amended +
  "method" : { CodeableConcept }, // Evaluation mechanism
  "code" : { CodeableConcept }, // Type of assessment
  "subject" : { Reference(Patient|Group) }, // R!  Who/what does assessment apply to?
  "encounter" : { Reference(Encounter) }, // Where was assessment performed?
  // occurrence[x]: When was assessment made?. One of these 2:
  "occurrenceDateTime" : "<dateTime>",
  "occurrencePeriod" : { Period },
  "condition" : { Reference(Condition) }, // Condition assessed
  "performer" : { Reference(Practitioner|PractitionerRole|Device) }, // Who did assessment?
  "reasonCode" : [{ CodeableConcept }], // Why the assessment was necessary?
  "reasonReference" : [{ Reference(Condition|Observation|DiagnosticReport|
   DocumentReference) }], // Why the assessment was necessary?
  "basis" : [{ Reference(Any) }], // Information used in assessment
  "prediction" : [{ // Outcome predicted
    "outcome" : { CodeableConcept }, // Possible outcome for the subject
    // probability[x]: Likelihood of specified outcome. One of these 2:
    "probabilityDecimal" : <decimal>,
    "probabilityRange" : { Range },
    "qualitativeRisk" : { CodeableConcept }, // Likelihood of specified outcome as a qualitative value
    "relativeRisk" : <decimal>, // Relative likelihood
    // when[x]: Timeframe or age range. One of these 2:
    "whenPeriod" : { Period },
    "whenRange" : { Range },
    "rationale" : "<string>" // Explanation of prediction
  }],
  "mitigation" : "<string>", // How to reduce risk
  "note" : [{ Annotation }] // Comments on the risk assessment
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:RiskAssessment;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:RiskAssessment.identifier [ Identifier ], ... ; # 0..* Unique identifier for the assessment
  fhir:RiskAssessment.basedOn [ Reference(Any) ]; # 0..1 Request fulfilled by this assessment
  fhir:RiskAssessment.parent [ Reference(Any) ]; # 0..1 Part of this occurrence
  fhir:RiskAssessment.status [ code ]; # 1..1 registered | preliminary | final | amended +
  fhir:RiskAssessment.method [ CodeableConcept ]; # 0..1 Evaluation mechanism
  fhir:RiskAssessment.code [ CodeableConcept ]; # 0..1 Type of assessment
  fhir:RiskAssessment.subject [ Reference(Patient|Group) ]; # 1..1 Who/what does assessment apply to?
  fhir:RiskAssessment.encounter [ Reference(Encounter) ]; # 0..1 Where was assessment performed?
  # RiskAssessment.occurrence[x] : 0..1 When was assessment made?. One of these 2
    fhir:RiskAssessment.occurrenceDateTime [ dateTime ]
    fhir:RiskAssessment.occurrencePeriod [ Period ]
  fhir:RiskAssessment.condition [ Reference(Condition) ]; # 0..1 Condition assessed
  fhir:RiskAssessment.performer [ Reference(Practitioner|PractitionerRole|Device) ]; # 0..1 Who did assessment?
  fhir:RiskAssessment.reasonCode [ CodeableConcept ], ... ; # 0..* Why the assessment was necessary?
  fhir:RiskAssessment.reasonReference [ Reference(Condition|Observation|DiagnosticReport|DocumentReference) ], ... ; # 0..* Why the assessment was necessary?
  fhir:RiskAssessment.basis [ Reference(Any) ], ... ; # 0..* Information used in assessment
  fhir:RiskAssessment.prediction [ # 0..* Outcome predicted
    fhir:RiskAssessment.prediction.outcome [ CodeableConcept ]; # 0..1 Possible outcome for the subject
    # RiskAssessment.prediction.probability[x] : 0..1 Likelihood of specified outcome. One of these 2
      fhir:RiskAssessment.prediction.probabilityDecimal [ decimal ]
      fhir:RiskAssessment.prediction.probabilityRange [ Range ]
    fhir:RiskAssessment.prediction.qualitativeRisk [ CodeableConcept ]; # 0..1 Likelihood of specified outcome as a qualitative value
    fhir:RiskAssessment.prediction.relativeRisk [ decimal ]; # 0..1 Relative likelihood
    # RiskAssessment.prediction.when[x] : 0..1 Timeframe or age range. One of these 2
      fhir:RiskAssessment.prediction.whenPeriod [ Period ]
      fhir:RiskAssessment.prediction.whenRange [ Range ]
    fhir:RiskAssessment.prediction.rationale [ string ]; # 0..1 Explanation of prediction
  ], ...;
  fhir:RiskAssessment.mitigation [ string ]; # 0..1 How to reduce risk
  fhir:RiskAssessment.note [ Annotation ], ... ; # 0..* Comments on the risk assessment
]

Changes since Release 3

RiskAssessment
RiskAssessment.identifier
  • Max Cardinality changed from 1 to *
RiskAssessment.status
  • Change value set from http://hl7.org/fhir/ValueSet/observation-status to http://hl7.org/fhir/ValueSet/observation-status|4.0.1
RiskAssessment.subject
  • Min Cardinality changed from 0 to 1
RiskAssessment.encounter
  • Added Element
RiskAssessment.performer
  • Type Reference: Added Target Type PractitionerRole
RiskAssessment.reasonCode
  • Added Element
RiskAssessment.reasonReference
  • Added Element
RiskAssessment.prediction.outcome
  • Min Cardinality changed from 1 to 0
RiskAssessment.note
  • Renamed from comment to note
  • Max Cardinality changed from 1 to *
  • Type changed from string to Annotation
RiskAssessment.context
  • deleted
RiskAssessment.reason[x]
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 4 tests that all execute ok. All tests pass round-trip testing and 3 r3 resources are invalid (0 errors).)

 

See the Profiles & Extensions and the alternate definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions & the dependency analysis

9.11.4.1 Terminology Bindings

PathDefinitionTypeReference
RiskAssessment.status The status of the risk assessment; e.g. preliminary, final, amended, etc.RequiredObservationStatus
RiskAssessment.method The mechanism or algorithm used to make the assessment; e.g. TIMI, PRISM, Cardiff Type 2 diabetes, etc.UnknownNo details provided yet
RiskAssessment.prediction.outcome The condition or other outcome; e.g. death, remission, amputation, infection, etc.UnknownNo details provided yet
RiskAssessment.prediction.qualitativeRisk The likelihood of the occurrence of a specified outcome.ExampleRiskProbability

9.11.4.2 Constraints

idLevelLocationDescriptionExpression
ras-1Rule RiskAssessment.prediction.probability[x]low and high must be percentages, if present(low.empty() or ((low.code = '%') and (low.system = %ucum))) and (high.empty() or ((high.code = '%') and (high.system = %ucum)))
ras-2Rule RiskAssessment.predictionMust be <= 100probability is decimal implies (probability as decimal) <= 100

9.11.5 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

NameTypeDescriptionExpressionIn Common
conditionreferenceCondition assessedRiskAssessment.condition
(Condition)
datedateWhen was assessment made?(RiskAssessment.occurrence as dateTime)17 Resources
encounterreferenceWhere was assessment performed?RiskAssessment.encounter
(Encounter)		12 Resources
identifiertokenUnique identifier for the assessmentRiskAssessment.identifier30 Resources
methodtokenEvaluation mechanismRiskAssessment.method
patientreferenceWho/what does assessment apply to?RiskAssessment.subject.where(resolve() is Patient)
(Patient)		33 Resources
performerreferenceWho did assessment?RiskAssessment.performer
(Practitioner, Device, PractitionerRole)
probabilitynumberLikelihood of specified outcomeRiskAssessment.prediction.probability
risktokenLikelihood of specified outcome as a qualitative valueRiskAssessment.prediction.qualitativeRisk
subjectreferenceWho/what does assessment apply to?RiskAssessment.subject
(Group, Patient)