HL7 FHIR Implementation Guide: Breast Cancer Data, Release 1 - US Realm (Draft for Comment 2)

This page is part of the Breast Cancer Data Logical Models and FHIR Profiles (v0.2.0: STU 1 Draft) based on FHIR R3. . For a full list of available versions, see the Directory of published versions

BreastSiteProfile

Definitions for oncology-BreastSite.

BodySite
Definition

A body site specific to the breast structure.

Control0..*
Alternate Namesanatomical location
InvariantsDefined on this element
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (: contained.text.empty())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (: contained.where(('#'+id in %resource.descendants().reference).not()).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
BodySite.id
Definition

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

Control0..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.

BodySite.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

Control0..1
TypeMeta
BodySite.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.

Control0..1
Typeuri
Is Modifiertrue
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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

BodySite.language
Definition

The base language in which the resource is written.

Control0..1
BindingA human language.
The codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable
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).

BodySite.text
Definition

A human-readable narrative that contains a summary of the resource, and may 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.

Control0..1 This element is affected by the following invariants: dom-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 in formation is added later.

BodySite.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.

Control0..*
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.

BodySite.extension
Definition

May be used to represent additional information that is not part of the basic definition of the resource. In order 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.

Control0..*
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.

BodySite.extension ([CanonicalType[http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-ClockDirection-extension]])
Definition

A direction indicated by an angle relative to 12 o'clock.

Control0..* This element is affected by the following invariants: ele-1
Type (Extension Type: Choice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: children().count() > id.count())
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
BodySite.extension ([CanonicalType[http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-DistanceFromBreastSiteToNipple-extension]])
Definition

Distance between the feature of interest (e.g., the tumor) and the nipple.

Control0..* This element is affected by the following invariants: ele-1
Type (Extension Type: Quantity)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: children().count() > id.count())
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
BodySite.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. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
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.

BodySite.identifier
Definition

Identifier for this instance of the anatomical location.

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
BodySite.active
Definition

Whether this body site is in active use.

Control0..1
Typeboolean
Is Modifiertrue
Requirements

Need to be able to mark a body site entry as not to be used because it was created in error.

Comments

This element is labeled as a modifier because it may be used to mark that the resource was created in error.

Default Valuetrue
BodySite.code
Definition

Code representing a body site specific to the breast structure.

Control1..1
BindingThe codes SHALL be taken from BreastSiteVS
TypeCodeableConcept
BodySite.qualifier
Definition

Qualifier to refine the anatomical location. These include qualifiers for laterality, relative location, directionality, number, and plane.

Control0..*
BindingConcepts modifying the anatomic location
For example codes, see Bodysite Location Qualifier
TypeCodeableConcept
BodySite.qualifier(cimi-element-Laterality)
Definition

Anatomical location or specimen further detailing the side(s) of interest.

Control0..1
BindingThe codes SHALL be taken from Laterality
TypeCodeableConcept
BodySite.qualifier(cimi-element-AnatomicalDirection)
Definition

Anatomical location or specimen further detailing directionality.

Control0..0
BindingThe codes SHALL be taken from AnatomicalDirectionVS
TypeCodeableConcept
BodySite.description
Definition

A summary, charactarization or explanation of the anatomic location.

Control0..1
Typestring
Comments

This description could include any visual markings used to orientate the viewer e.g. external reference points, special sutures, ink markings.

BodySite.image
Definition

Image or images used to identify a location.

Control0..*
TypeAttachment
BodySite.patient
Definition

The person to which the body site belongs.

Control1..1
TypeReference(Patient)