Data Exchange For Quality Measures Implementation Guide
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This page is part of the Da Vinci Data Exchange for Quality Measures (DEQM) FHIR IG (v5.0.0-ballot: STU5 (v5.0.0) Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 4.0.0. For a full list of available versions, see the Directory of published versions

Resource Profile: DetailedCareGapGuidanceResponse - Detailed Descriptions

Active as of 2024-08-27

Definitions for the gaps-guidanceresponse-detailedcaregap resource profile.

Guidance on how to interpret the contents of this table can be found here

0. GuidanceResponse
2. GuidanceResponse.reasonCode
BindingThe codes SHOULD be taken from Care Gap Reasons Value Set
(preferred to http://hl7.org/fhir/us/davinci-deqm/ValueSet/care-gap-reason)
4. GuidanceResponse.reasonCode.extension:detail
Slice Namedetail
Definition

Refers back to the Resource and data element that cause the care gap defined by the reasonCode

ShortWhich data element attribute is the cause of the care gap
Control0..1
TypeExtension(Reason Detail) (Complex Extension)
6. GuidanceResponse.dataRequirement
8. GuidanceResponse.dataRequirement.extension:valueFilter
Slice NamevalueFilter
Definition

Value Set filters specify additional constraints on the data for non coded or temporal types. Each value filter defines an additional constraint on the data, i.e. code filters are AND'ed, not OR'ed.

ShortWhat values are expected
Control0..*
TypeExtension(Value Filter) (Complex Extension)

Guidance on how to interpret the contents of this table can be found here

0. GuidanceResponse
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.

ShortThe formal response to a guidance request
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-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 or SHALL refer to the containing resource (contained.where((('#'+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(canonical) = '#').exists()).not()).trace('unmatched', id).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())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. GuidanceResponse.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.

ShortA set of rules under which this content was created
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.

Control0..1
Typeuri
Is Modifiertrue because 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
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. GuidanceResponse.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).

ShortExtensions that cannot be ignored
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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
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
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. GuidanceResponse.module[x]
Definition

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

ShortWhat guidance was requested
Control1..1
TypeChoice of: uri, canonical, CodeableConcept
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. GuidanceResponse.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.

Shortsuccess | data-requested | data-required | in-progress | failure | entered-in-error
Comments

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

Control1..1
BindingThe codes SHALL be taken from GuidanceResponseStatushttp://hl7.org/fhir/ValueSet/guidance-response-status|4.0.1
(required to http://hl7.org/fhir/ValueSet/guidance-response-status|4.0.1)

The status of a guidance response.

Typecode
Is Modifiertrue because 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
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. GuidanceResponse.reasonCode
Definition

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

ShortWhy guidance is needed
Control0..*
BindingThe codes SHOULD be taken from For codes, see Care Gap Reasons Value Set
(preferred to http://hl7.org/fhir/us/davinci-deqm/ValueSet/care-gap-reason)
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. GuidanceResponse.reasonCode.extension:detail
Slice Namedetail
Definition

Refers back to the Resource and data element that cause the care gap defined by the reasonCode

ShortWhich data element attribute is the cause of the care gap
Control0..1
TypeExtension(Reason Detail) (Complex Extension)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())

Guidance on how to interpret the contents of this table can be found here

0. GuidanceResponse
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.

ShortThe formal response to a guidance request
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-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 or SHALL refer to the containing resource (contained.where((('#'+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(canonical) = '#').exists()).not()).trace('unmatched', id).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())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. GuidanceResponse.id
Definition

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

ShortLogical id of this artifact
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.

Control0..1
Typeid
Is Modifierfalse
Summarytrue
4. GuidanceResponse.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.

ShortMetadata about the resource
Control0..1
TypeMeta
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. GuidanceResponse.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.

ShortA set of rules under which this content was created
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.

Control0..1
Typeuri
Is Modifiertrue because 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
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. GuidanceResponse.language
Definition

The base language in which the resource is written.

ShortLanguage of the resource content
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).

Control0..1
BindingThe codes SHOULD be taken from CommonLanguages
(preferred to http://hl7.org/fhir/ValueSet/languages)

A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. GuidanceResponse.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.

ShortText summary of the resource, for human interpretation
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.

Control0..1
TypeNarrative
Is Modifierfalse
Summaryfalse
Alternate Namesnarrative, html, xhtml, display
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. GuidanceResponse.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.

ShortContained, inline 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.

Control0..*
TypeResource
Is Modifierfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
14. GuidanceResponse.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.

ShortAdditional content defined by implementations
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.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
16. GuidanceResponse.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).

ShortExtensions that cannot be ignored
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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
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
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. GuidanceResponse.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.

ShortThe identifier of the request associated with this response, if any
Control0..1
TypeIdentifier
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. GuidanceResponse.identifier
Definition

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

ShortBusiness identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. GuidanceResponse.module[x]
Definition

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

ShortWhat guidance was requested
Control1..1
TypeChoice of: uri, canonical, CodeableConcept
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. GuidanceResponse.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.

Shortsuccess | data-requested | data-required | in-progress | failure | entered-in-error
Comments

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

Control1..1
BindingThe codes SHALL be taken from GuidanceResponseStatus
(required to http://hl7.org/fhir/ValueSet/guidance-response-status|4.0.1)

The status of a guidance response.

Typecode
Is Modifiertrue because 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
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. GuidanceResponse.subject
Definition

The patient for which the request was processed.

ShortPatient the request was performed for
Control0..1
TypeReference(Patient, Group)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. GuidanceResponse.encounter
Definition

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

ShortEncounter during which the response was returned
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.

Control0..1
TypeReference(Encounter)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. GuidanceResponse.occurrenceDateTime
Definition

Indicates when the guidance response was processed.

ShortWhen the guidance response was processed
Control0..1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. GuidanceResponse.performer
Definition

Provides a reference to the device that performed the guidance.

ShortDevice returning the guidance
Control0..1
TypeReference(Device)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. GuidanceResponse.reasonCode
Definition

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

ShortWhy guidance is needed
Control0..*
BindingThe codes SHOULD be taken from Care Gap Reasons Value Set
(preferred to http://hl7.org/fhir/us/davinci-deqm/ValueSet/care-gap-reason)
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. GuidanceResponse.reasonCode.id
Definition

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

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
38. GuidanceResponse.reasonCode.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.

ShortAdditional content defined by implementations
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.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on GuidanceResponse.reasonCode.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 40. GuidanceResponse.reasonCode.extension:detail
    Slice Namedetail
    Definition

    Refers back to the Resource and data element that cause the care gap defined by the reasonCode

    ShortWhich data element attribute is the cause of the care gap
    Control0..1
    TypeExtension(Reason Detail) (Complex Extension)
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    42. GuidanceResponse.reasonCode.coding
    Definition

    A reference to a code defined by a terminology system.

    ShortCode defined by a terminology system
    Comments

    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

    Control0..*
    TypeCoding
    Is Modifierfalse
    Summarytrue
    Requirements

    Allows for alternative encodings within a code system, and translations to other code systems.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    44. GuidanceResponse.reasonCode.text
    Definition

    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

    ShortPlain text representation of the concept
    Comments

    Very often the text is the same as a displayName of one of the codings.

    Control0..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    46. GuidanceResponse.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.

    ShortWhy guidance is needed
    Control0..*
    TypeReference(Condition, Observation, DiagnosticReport, DocumentReference)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    48. GuidanceResponse.note
    Definition

    Provides a mechanism to communicate additional information about the response.

    ShortAdditional notes about the response
    Control0..*
    TypeAnnotation
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    50. GuidanceResponse.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.

    ShortMessages resulting from the evaluation of the artifact or artifacts
    Control0..*
    TypeReference(OperationOutcome)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    52. GuidanceResponse.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.

    ShortThe output parameters of the evaluation, if any
    Control0..1
    TypeReference(Parameters)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    54. GuidanceResponse.result
    Definition

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

    ShortProposed actions, if any
    Control0..1
    TypeReference(CarePlan, RequestGroup)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    56. GuidanceResponse.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.

    ShortAdditional required data
    Control0..*
    TypeDataRequirement
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    58. GuidanceResponse.dataRequirement.id
    Definition

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

    ShortUnique id for inter-element referencing
    Control0..1
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    60. GuidanceResponse.dataRequirement.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.

    ShortAdditional content defined by implementations
    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.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on GuidanceResponse.dataRequirement.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 62. GuidanceResponse.dataRequirement.extension:valueFilter
      Slice NamevalueFilter
      Definition

      Value Set filters specify additional constraints on the data for non coded or temporal types. Each value filter defines an additional constraint on the data, i.e. code filters are AND'ed, not OR'ed.

      ShortWhat values are expected
      Control0..*
      TypeExtension(Value Filter) (Complex Extension)
      Is Modifierfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      64. GuidanceResponse.dataRequirement.type
      Definition

      The type of the required data, specified as the type name of a resource. For profiles, this value is set to the type of the base resource of the profile.

      ShortThe type of the required data
      Control1..1
      BindingThe codes SHALL be taken from FHIRAllTypes
      (required to http://hl7.org/fhir/ValueSet/all-types|4.0.1)

      A list of all the concrete types defined in this version of the FHIR specification - Abstract Types, Data Types and Resource Types.

      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      66. GuidanceResponse.dataRequirement.profile
      Definition

      The profile of the required data, specified as the uri of the profile definition.

      ShortThe profile of the required data
      Control0..*
      Typecanonical(StructureDefinition)
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      68. GuidanceResponse.dataRequirement.subject[x]
      Definition

      The intended subjects of the data requirement. If this element is not provided, a Patient subject is assumed.

      ShortE.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device
      Comments

      The subject of a data requirement is critical, as the data being specified is determined with respect to a particular subject. This corresponds roughly to the notion of a Compartment in that it limits what data is available based on its relationship to the subject. In CQL, this corresponds to the context declaration.

      Control0..1
      BindingUnless not suitable, these codes SHALL be taken from SubjectType
      (extensible to http://hl7.org/fhir/ValueSet/subject-type)

      The possible types of subjects for a data requirement (E.g., Patient, Practitioner, Organization, Location, etc.).

      TypeChoice of: CodeableConcept, Reference(Group)
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Summarytrue
      Meaning if MissingPatient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      70. GuidanceResponse.dataRequirement.mustSupport
      Definition

      Indicates that specific elements of the type are referenced by the knowledge module and must be supported by the consumer in order to obtain an effective evaluation. This does not mean that a value is required for this element, only that the consuming system must understand the element and be able to provide values for it if they are available.

      The value of mustSupport SHALL be a FHIRPath resolveable on the type of the DataRequirement. The path SHALL consist only of identifiers, constant indexers, and .resolve() (see the Simple FHIRPath Profile for full details).

      ShortIndicates specific structure elements that are referenced by the knowledge module
      Control0..*
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      72. GuidanceResponse.dataRequirement.codeFilter
      Definition

      Code filters specify additional constraints on the data, specifying the value set of interest for a particular element of the data. Each code filter defines an additional constraint on the data, i.e. code filters are AND'ed, not OR'ed.

      ShortWhat codes are expected
      Control0..*
      TypeElement
      Is Modifierfalse
      Summarytrue
      Invariantsdrq-1: Either a path or a searchParam must be provided, but not both (path.exists() xor searchParam.exists())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      74. GuidanceResponse.dataRequirement.codeFilter.id
      Definition

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

      ShortUnique id for inter-element referencing
      Control0..1
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      76. GuidanceResponse.dataRequirement.codeFilter.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.

      ShortAdditional content defined by implementations
      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.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on GuidanceResponse.dataRequirement.codeFilter.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 78. GuidanceResponse.dataRequirement.codeFilter.path
        Definition

        The code-valued attribute of the filter. The specified path SHALL be a FHIRPath resolveable on the specified type of the DataRequirement, and SHALL consist only of identifiers, constant indexers, and .resolve(). The path is allowed to contain qualifiers (.) to traverse sub-elements, as well as indexers ([x]) to traverse multiple-cardinality sub-elements (see the Simple FHIRPath Profile for full details). Note that the index must be an integer constant. The path must resolve to an element of type code, Coding, or CodeableConcept.

        ShortA code-valued attribute to filter on
        Comments

        The path attribute contains a Simple FHIRPath Subset that allows path traversal, but not calculation.

        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        80. GuidanceResponse.dataRequirement.codeFilter.searchParam
        Definition

        A token parameter that refers to a search parameter defined on the specified type of the DataRequirement, and which searches on elements of type code, Coding, or CodeableConcept.

        ShortA coded (token) parameter to search on
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        82. GuidanceResponse.dataRequirement.codeFilter.valueSet
        Definition

        The valueset for the code filter. The valueSet and code elements are additive. If valueSet is specified, the filter will return only those data items for which the value of the code-valued element specified in the path is a member of the specified valueset.

        ShortValueset for the filter
        Control0..1
        Typecanonical(ValueSet)
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        84. GuidanceResponse.dataRequirement.codeFilter.code
        Definition

        The codes for the code filter. If values are given, the filter will return only those data items for which the code-valued attribute specified by the path has a value that is one of the specified codes. If codes are specified in addition to a value set, the filter returns items matching a code in the value set or one of the specified codes.

        ShortWhat code is expected
        Control0..*
        TypeCoding
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        86. GuidanceResponse.dataRequirement.dateFilter
        Definition

        Date filters specify additional constraints on the data in terms of the applicable date range for specific elements. Each date filter specifies an additional constraint on the data, i.e. date filters are AND'ed, not OR'ed.

        ShortWhat dates/date ranges are expected
        Control0..*
        TypeElement
        Is Modifierfalse
        Summarytrue
        Invariantsdrq-2: Either a path or a searchParam must be provided, but not both (path.exists() xor searchParam.exists())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        88. GuidanceResponse.dataRequirement.dateFilter.id
        Definition

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

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        90. GuidanceResponse.dataRequirement.dateFilter.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.

        ShortAdditional content defined by implementations
        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.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on GuidanceResponse.dataRequirement.dateFilter.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 92. GuidanceResponse.dataRequirement.dateFilter.path
          Definition

          The date-valued attribute of the filter. The specified path SHALL be a FHIRPath resolveable on the specified type of the DataRequirement, and SHALL consist only of identifiers, constant indexers, and .resolve(). The path is allowed to contain qualifiers (.) to traverse sub-elements, as well as indexers ([x]) to traverse multiple-cardinality sub-elements (see the Simple FHIRPath Profile for full details). Note that the index must be an integer constant. The path must resolve to an element of type date, dateTime, Period, Schedule, or Timing.

          ShortA date-valued attribute to filter on
          Comments

          The path attribute contains a Simple FHIR Subset that allows path traversal, but not calculation.

          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          94. GuidanceResponse.dataRequirement.dateFilter.searchParam
          Definition

          A date parameter that refers to a search parameter defined on the specified type of the DataRequirement, and which searches on elements of type date, dateTime, Period, Schedule, or Timing.

          ShortA date valued parameter to search on
          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          96. GuidanceResponse.dataRequirement.dateFilter.value[x]
          Definition

          The value of the filter. If period is specified, the filter will return only those data items that fall within the bounds determined by the Period, inclusive of the period boundaries. If dateTime is specified, the filter will return only those data items that are equal to the specified dateTime. If a Duration is specified, the filter will return only those data items that fall within Duration before now.

          ShortThe value of the filter, as a Period, DateTime, or Duration value
          Control0..1
          TypeChoice of: dateTime, Period, Duration
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          98. GuidanceResponse.dataRequirement.limit
          Definition

          Specifies a maximum number of results that are required (uses the _count search parameter).

          ShortNumber of results
          Comments

          This element can be used in combination with the sort element to specify quota requirements such as "the most recent 5" or "the highest 5".

          Control0..1
          TypepositiveInt
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Enables the requirement "most recent 5 results" to be expressed.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          100. GuidanceResponse.dataRequirement.sort
          Definition

          Specifies the order of the results to be returned.

          ShortOrder of the results
          Comments

          This element can be used in combination with the sort element to specify quota requirements such as "the most recent 5" or "the highest 5". When multiple sorts are specified, they are applied in the order they appear in the resource.

          Control0..*
          TypeElement
          Is Modifierfalse
          Summarytrue
          Requirements

          Enables the requirement "most recent 5 results" to be expressed.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          102. GuidanceResponse.dataRequirement.sort.id
          Definition

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

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          104. GuidanceResponse.dataRequirement.sort.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.

          ShortAdditional content defined by implementations
          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.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on GuidanceResponse.dataRequirement.sort.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 106. GuidanceResponse.dataRequirement.sort.path
            Definition

            The attribute of the sort. The specified path must be resolvable from the type of the required data. The path is allowed to contain qualifiers (.) to traverse sub-elements, as well as indexers ([x]) to traverse multiple-cardinality sub-elements. Note that the index must be an integer constant.

            ShortThe name of the attribute to perform the sort
            Control1..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            108. GuidanceResponse.dataRequirement.sort.direction
            Definition

            The direction of the sort, ascending or descending.

            Shortascending | descending
            Control1..1
            BindingThe codes SHALL be taken from SortDirection
            (required to http://hl7.org/fhir/ValueSet/sort-direction|4.0.1)

            The possible sort directions, ascending or descending.

            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))