Electronic Long-Term Services and Supports (eLTSS) Release 1 - US Realm
2.0.0 - STU2 United States of America flag

This page is part of the electronic Long-Term Services and Supports Implementation Guide (v2.0.0: STU2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Resource Profile: RiskAssessment_eltss - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 2

Definitions for the RiskAssessment-eltss resource profile.

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

0. RiskAssessment
2. RiskAssessment.extension
SlicingThis element introduces a set of slices on RiskAssessment.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. RiskAssessment.extension:riskPlan
    Slice NameriskPlan
    Control0..*
    TypeExtension(RiskPlan) (Extension Type: Reference(US Core DocumentReference Profile))
    Must Supporttrue
    6. RiskAssessment.extension:resource-pertainsToGoal
    Slice Nameresource-pertainsToGoal
    ShortThe resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources.
    Control0..*
    TypeExtension(ServiceRequest Pertains To Goal) (Extension Type: Reference(Goal))
    Must Supporttrue
    8. RiskAssessment.subject
    TypeReference(Patient_eltss)
    10. RiskAssessment.encounter
    TypeReference(US Core Encounter Profile)
    12. RiskAssessment.condition
    TypeReference(Condition_eltss)
    14. RiskAssessment.performer
    TypeReference(Practitioner_eltss, eLTSS PractitionerRole Profile, US Core Implantable Device Profile, Device)
    16. RiskAssessment.reasonReference
    TypeReference(Condition_eltss, Observation_eltss, US Core DiagnosticReport Profile for Report and Note Exchange, US Core DocumentReference Profile)
    18. RiskAssessment.prediction
    Definition

    An aspect of a person’s life, behavior, environmental exposure, personal characteristic, or barrier that increases the likelihood of disease, condition, injury to self or others, or interaction with the criminal justice system.

    ShortIdentified Risk
    20. RiskAssessment.prediction.outcome
    BindingFor example codes, see hl7VS-patientOutcome
    (example to http://terminology.hl7.org/ValueSet/v2-0241)

    The condition or other outcome; e.g. death, remission, amputation, infection, etc.

    22. RiskAssessment.mitigation
    Definition

    Description of planned activities to minimize identified risks that endanger the person's health and safety. This can be included as free text or attachment.

    ShortRisk Management Plan
    Must Supporttrue

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

    0. RiskAssessment
    Definition

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

    ShortPotential outcomes for a subject with likelihood
    Control0..*
    Is Modifierfalse
    Summaryfalse
    Alternate NamesPrognosis
    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. RiskAssessment.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. RiskAssessment.extension
    Definition

    An Extension


    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.

    ShortExtensionAdditional 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 RiskAssessment.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 6. RiskAssessment.extension:riskPlan
      Slice NameriskPlan
      Definition

      Risk Management Plan eLTSS data set element

      ShortExtension
      Control0..*
      This element is affected by the following invariants: ele-1
      TypeExtension(RiskPlan) (Extension Type: Reference(US Core DocumentReference Profile))
      Is Modifierfalse
      Must Supporttrue
      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())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      8. RiskAssessment.extension:resource-pertainsToGoal
      Slice Nameresource-pertainsToGoal
      Definition

      Indicates that the resource is related to either the measurement, achievement or progress towards the referenced goal. For example, a Procedure to exercise pertainsToGoal of losing weight.

      ShortThe resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources.
      Comments

      This extension is limited to subject-specific activity-related resources (events & intents). I.e. This can't be put on Goal or Patient. This association isn't for the purpose of goal management, but for things such as noting that a particular observation result, prescription or other activity is pertinent to the achievement (or possibly non-achievement) of the referenced goal.

      Control0..*
      TypeExtension(ServiceRequest Pertains To Goal) (Extension Type: Reference(Goal))
      Is Modifierfalse
      Must Supporttrue
      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())
      ele-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())
      10. RiskAssessment.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())
      12. RiskAssessment.status
      Definition

      The status of the RiskAssessment, using the same statuses as an Observation.

      Shortregistered | preliminary | final | amended +
      Control1..1
      BindingThe codes SHALL be taken from ObservationStatushttp://hl7.org/fhir/ValueSet/observation-status|4.0.1
      (required to http://hl7.org/fhir/ValueSet/observation-status|4.0.1)

      The status of the risk assessment; e.g. preliminary, final, amended, etc.

      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()))
      14. RiskAssessment.subject
      Definition

      The patient or group the risk assessment applies to.

      ShortWho/what does assessment apply to?
      Control1..1
      TypeReference(Patient_eltss, Patient, Group)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. RiskAssessment.encounter
      Definition

      The encounter where the assessment was performed.

      ShortWhere was assessment performed?
      Control0..1
      TypeReference(US Core Encounter Profile, Encounter)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. RiskAssessment.condition
      Definition

      For assessments or prognosis specific to a particular condition, indicates the condition being assessed.

      ShortCondition assessed
      Control0..1
      TypeReference(Condition_eltss, Condition)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. RiskAssessment.performer
      Definition

      The provider or software application that performed the assessment.

      ShortWho did assessment?
      Control0..1
      TypeReference(Practitioner_eltss, eLTSS PractitionerRole Profile, US Core Implantable Device Profile, Device, Practitioner, PractitionerRole)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. RiskAssessment.reasonReference
      Definition

      Resources supporting the reason the risk assessment was performed.

      ShortWhy the assessment was necessary?
      Control0..*
      TypeReference(Condition_eltss, Observation_eltss, US Core DiagnosticReport Profile for Report and Note Exchange, US Core DocumentReference Profile, Condition, Observation, DiagnosticReport, DocumentReference)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. RiskAssessment.prediction
      Definition

      An aspect of a person’s life, behavior, environmental exposure, personal characteristic, or barrier that increases the likelihood of disease, condition, injury to self or others, or interaction with the criminal justice system.


      Describes the expected outcome for the subject.

      ShortIdentified RiskOutcome predicted
      Comments

      Multiple repetitions can be used to identify the same type of outcome in different timeframes as well as different types of outcomes.

      Control0..*
      TypeBackboneElement
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ras-2: Must be <= 100 (probability is decimal implies (probability as decimal) <= 100)
      ras-2: Must be <= 100 (probability is decimal implies (probability as decimal) <= 100)
      26. RiskAssessment.prediction.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

      ShortExtensions that cannot be ignored even if unrecognized
      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 element that contains them
      Summarytrue
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content, modifiers
      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())
      28. RiskAssessment.prediction.outcome
      Definition

      One of the potential outcomes for the patient (e.g. remission, death, a particular condition).

      ShortPossible outcome for the subject
      Control0..1
      BindingFor example codes, see hl7VS-patientOutcome
      (example to http://terminology.hl7.org/ValueSet/v2-0241)

      The condition or other outcome; e.g. death, remission, amputation, infection, etc.

      TypeCodeableConcept
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. RiskAssessment.mitigation
      Definition

      Description of planned activities to minimize identified risks that endanger the person's health and safety. This can be included as free text or attachment.


      A description of the steps that might be taken to reduce the identified risk(s).

      ShortRisk Management PlanHow to reduce risk
      Control0..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summaryfalse
      Requirements

      One of the main reasons for assessing risks is to identify whether interventional steps are needed to reduce risk.

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

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

      0. RiskAssessment
      Definition

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

      ShortPotential outcomes for a subject with likelihood
      Control0..*
      Is Modifierfalse
      Summaryfalse
      Alternate NamesPrognosis
      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. RiskAssessment.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. RiskAssessment.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. RiskAssessment.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. RiskAssessment.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. RiskAssessment.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. RiskAssessment.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. RiskAssessment.extension
      Definition

      An Extension

      ShortExtension
      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      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 RiskAssessment.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 16. RiskAssessment.extension:riskPlan
        Slice NameriskPlan
        Definition

        Risk Management Plan eLTSS data set element

        ShortExtension
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension(RiskPlan) (Extension Type: Reference(US Core DocumentReference Profile))
        Is Modifierfalse
        Must Supporttrue
        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. RiskAssessment.extension:resource-pertainsToGoal
        Slice Nameresource-pertainsToGoal
        Definition

        Indicates that the resource is related to either the measurement, achievement or progress towards the referenced goal. For example, a Procedure to exercise pertainsToGoal of losing weight.

        ShortThe resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources.
        Comments

        This extension is limited to subject-specific activity-related resources (events & intents). I.e. This can't be put on Goal or Patient. This association isn't for the purpose of goal management, but for things such as noting that a particular observation result, prescription or other activity is pertinent to the achievement (or possibly non-achievement) of the referenced goal.

        Control0..*
        TypeExtension(ServiceRequest Pertains To Goal) (Extension Type: Reference(Goal))
        Is Modifierfalse
        Must Supporttrue
        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())
        20. RiskAssessment.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())
        22. RiskAssessment.identifier
        Definition

        Business identifier assigned to the risk assessment.

        ShortUnique identifier for the assessment
        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()))
        24. RiskAssessment.basedOn
        Definition

        A reference to the request that is fulfilled by this risk assessment.

        ShortRequest fulfilled by this assessment
        Control0..1
        TypeReference(Resource)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. RiskAssessment.parent
        Definition

        A reference to a resource that this risk assessment is part of, such as a Procedure.

        ShortPart of this occurrence
        Control0..1
        TypeReference(Resource)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. RiskAssessment.status
        Definition

        The status of the RiskAssessment, using the same statuses as an Observation.

        Shortregistered | preliminary | final | amended +
        Control1..1
        BindingThe codes SHALL be taken from ObservationStatus
        (required to http://hl7.org/fhir/ValueSet/observation-status|4.0.1)

        The status of the risk assessment; e.g. preliminary, final, amended, etc.

        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()))
        30. RiskAssessment.method
        Definition

        The algorithm, process or mechanism used to evaluate the risk.

        ShortEvaluation mechanism
        Control0..1
        Binding

        The mechanism or algorithm used to make the assessment; e.g. TIMI, PRISM, Cardiff Type 2 diabetes, etc.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Requirements

        The method can influence the results of the assessment.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. RiskAssessment.code
        Definition

        The type of the risk assessment performed.

        ShortType of assessment
        Control0..1
        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. RiskAssessment.subject
        Definition

        The patient or group the risk assessment applies to.

        ShortWho/what does assessment apply to?
        Control1..1
        TypeReference(Patient_eltss)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. RiskAssessment.encounter
        Definition

        The encounter where the assessment was performed.

        ShortWhere was assessment performed?
        Control0..1
        TypeReference(US Core Encounter Profile)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. RiskAssessment.occurrence[x]
        Definition

        The date (and possibly time) the risk assessment was performed.

        ShortWhen was assessment made?
        Control0..1
        TypeChoice of: dateTime, Period
        [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
        Requirements

        The assessment results lose validity the more time elapses from when they are first made.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. RiskAssessment.condition
        Definition

        For assessments or prognosis specific to a particular condition, indicates the condition being assessed.

        ShortCondition assessed
        Control0..1
        TypeReference(Condition_eltss)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. RiskAssessment.performer
        Definition

        The provider or software application that performed the assessment.

        ShortWho did assessment?
        Control0..1
        TypeReference(Practitioner_eltss, eLTSS PractitionerRole Profile, US Core Implantable Device Profile, Device)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. RiskAssessment.reasonCode
        Definition

        The reason the risk assessment was performed.

        ShortWhy the assessment was necessary?
        Control0..*
        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. RiskAssessment.reasonReference
        Definition

        Resources supporting the reason the risk assessment was performed.

        ShortWhy the assessment was necessary?
        Control0..*
        TypeReference(Condition_eltss, Observation_eltss, US Core DiagnosticReport Profile for Report and Note Exchange, US Core DocumentReference Profile)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. RiskAssessment.basis
        Definition

        Indicates the source data considered as part of the assessment (for example, FamilyHistory, Observations, Procedures, Conditions, etc.).

        ShortInformation used in assessment
        Control0..*
        TypeReference(Resource)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. RiskAssessment.prediction
        Definition

        An aspect of a person’s life, behavior, environmental exposure, personal characteristic, or barrier that increases the likelihood of disease, condition, injury to self or others, or interaction with the criminal justice system.

        ShortIdentified Risk
        Comments

        Multiple repetitions can be used to identify the same type of outcome in different timeframes as well as different types of outcomes.

        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ras-2: Must be <= 100 (probability is decimal implies (probability as decimal) <= 100)
        52. RiskAssessment.prediction.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
        54. RiskAssessment.prediction.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())
        56. RiskAssessment.prediction.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

        ShortExtensions that cannot be ignored even if unrecognized
        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 element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        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())
        58. RiskAssessment.prediction.outcome
        Definition

        One of the potential outcomes for the patient (e.g. remission, death, a particular condition).

        ShortPossible outcome for the subject
        Control0..1
        BindingFor example codes, see hl7VS-patientOutcome
        (example to http://terminology.hl7.org/ValueSet/v2-0241)

        The condition or other outcome; e.g. death, remission, amputation, infection, etc.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        60. RiskAssessment.prediction.probability[x]
        Definition

        Indicates how likely the outcome is (in the specified timeframe).

        ShortLikelihood of specified outcome
        Comments

        If range is used, it represents the lower and upper bounds of certainty; e.g. 40-60% Decimal values are expressed as percentages as well (max = 100).

        Control0..1
        TypeChoice of: decimal, Range
        [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
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ras-1: 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))))
        62. RiskAssessment.prediction.qualitativeRisk
        Definition

        Indicates how likely the outcome is (in the specified timeframe), expressed as a qualitative value (e.g. low, medium, or high).

        ShortLikelihood of specified outcome as a qualitative value
        Control0..1
        BindingFor example codes, see RiskProbability
        (example to http://hl7.org/fhir/ValueSet/risk-probability)

        The likelihood of the occurrence of a specified outcome.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        64. RiskAssessment.prediction.relativeRisk
        Definition

        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.).

        ShortRelative likelihood
        Control0..1
        Typedecimal
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Requirements

        Absolute risk is less meaningful than relative risk.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        66. RiskAssessment.prediction.when[x]
        Definition

        Indicates the period of time or age range of the subject to which the specified probability applies.

        ShortTimeframe or age range
        Comments

        If not specified, the risk applies "over the subject's lifespan".

        Control0..1
        TypeChoice of: Period, Range
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        68. RiskAssessment.prediction.rationale
        Definition

        Additional information explaining the basis for the prediction.

        ShortExplanation of prediction
        Control0..1
        Typestring
        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()))
        70. RiskAssessment.mitigation
        Definition

        Description of planned activities to minimize identified risks that endanger the person's health and safety. This can be included as free text or attachment.

        ShortRisk Management Plan
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summaryfalse
        Requirements

        One of the main reasons for assessing risks is to identify whether interventional steps are needed to reduce risk.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        72. RiskAssessment.note
        Definition

        Additional comments about the risk assessment.

        ShortComments on the risk assessment
        Control0..*
        TypeAnnotation
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))