This page is part of the Clinical Guidelines (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

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Resource Profile: CPG Detected Issue

Documents a detected issue within the context of a computable clinical practice guideline

Usage:

• Refer to this Resource Profile: CPG Record Detected Issue Task
• Examples for this Resource Profile: DetectedIssue/di-scenario4

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from DetectedIssue

Name	Flags	Card.	Type	Description & Constraints
DetectedIssue		0..*	DetectedIssue	Clinical issue with action
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
instantiatesCaseFeature	S	0..1	canonical(CPG Case Feature Definition)	CPG Instantiates Case Feature Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-instantiatesCaseFeature
caseFeatureType	S	0..1	code	CPG Case Feature Type Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeatureType Binding: CPG Case Feature Type Value Set (required): Whether the case feature is asserted or inferred
caseFeaturePertinence	S	0..1	code	CPG Case Feature Pertinence Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeaturePertinence Binding: CPG Case Feature Pertinence Value Set (required): Describes the pertinence of a case feature
status	S	1..1	code	registered | preliminary | final | amended +
code		1..1	CodeableConcept	Issue Category, e.g. drug-drug, duplicate therapy, etc.
patient	S	0..1	Reference(CPG Patient)	Associated patient
evidence	S	0..*	BackboneElement	Supporting evidence
code	S	0..*	CodeableConcept	Manifestation
detail	S	0..*	Reference(Resource)	Supporting information
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
DetectedIssue		0..*	DetectedIssue	Clinical issue with action
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
instantiatesCaseFeature	S	0..1	canonical(CPG Case Feature Definition)	CPG Instantiates Case Feature Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-instantiatesCaseFeature
caseFeatureType	S	0..1	code	CPG Case Feature Type Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeatureType Binding: CPG Case Feature Type Value Set (required): Whether the case feature is asserted or inferred
caseFeaturePertinence	S	0..1	code	CPG Case Feature Pertinence Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeaturePertinence Binding: CPG Case Feature Pertinence Value Set (required): Describes the pertinence of a case feature
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Indicates the status of the identified issue.
code	Σ	1..1	CodeableConcept	Issue Category, e.g. drug-drug, duplicate therapy, etc. Binding: DetectedIssueCategory (preferred): Codes identifying the general type of detected issue; e.g. Drug-drug interaction, Timing issue, Duplicate therapy, etc.
patient	SΣ	0..1	Reference(CPG Patient)	Associated patient
evidence	S	0..*	BackboneElement	Supporting evidence
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..*	CodeableConcept	Manifestation Binding: ManifestationAndSymptomCodes (example): Codes that describes the types of evidence for a detected issue.
detail	S	0..*	Reference(Resource)	Supporting information
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DetectedIssue.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
DetectedIssue.code	preferred	DetectedIssueCategory http://hl7.org/fhir/ValueSet/detectedissue-category from the FHIR Standard
DetectedIssue.evidence.code	example	ManifestationAndSymptomCodes http://hl7.org/fhir/ValueSet/manifestation-or-symptom from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DetectedIssue	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DetectedIssue	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	error	DetectedIssue	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	error	DetectedIssue	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DetectedIssue	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints
DetectedIssue		0..*	DetectedIssue	Clinical issue with action
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
instantiatesCaseFeature	S	0..1	canonical(CPG Case Feature Definition)	CPG Instantiates Case Feature Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-instantiatesCaseFeature
caseFeatureType	S	0..1	code	CPG Case Feature Type Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeatureType Binding: CPG Case Feature Type Value Set (required): Whether the case feature is asserted or inferred
caseFeaturePertinence	S	0..1	code	CPG Case Feature Pertinence Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeaturePertinence Binding: CPG Case Feature Pertinence Value Set (required): Describes the pertinence of a case feature
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Unique id for the detected issue
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Indicates the status of the identified issue.
code	Σ	1..1	CodeableConcept	Issue Category, e.g. drug-drug, duplicate therapy, etc. Binding: DetectedIssueCategory (preferred): Codes identifying the general type of detected issue; e.g. Drug-drug interaction, Timing issue, Duplicate therapy, etc.
severity	Σ	0..1	code	high | moderate | low Binding: DetectedIssueSeverity (required): Indicates the potential degree of impact of the identified issue on the patient.
patient	SΣ	0..1	Reference(CPG Patient)	Associated patient
identified[x]	Σ	0..1		When identified
identifiedDateTime			dateTime
identifiedPeriod			Period
author	Σ	0..1	Reference(Practitioner | PractitionerRole | Device)	The provider or device that identified the issue
implicated	Σ	0..*	Reference(Resource)	Problem resource
evidence	S	0..*	BackboneElement	Supporting evidence
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..*	CodeableConcept	Manifestation Binding: ManifestationAndSymptomCodes (example): Codes that describes the types of evidence for a detected issue.
detail	S	0..*	Reference(Resource)	Supporting information
detail		0..1	string	Description and context
reference		0..1	uri	Authority for issue
mitigation		0..*	BackboneElement	Step taken to address
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
action		1..1	CodeableConcept	What mitigation? Binding: DetectedIssueMitigationAction (preferred): Codes describing steps taken to resolve the issue or other circumstances that mitigate the risk associated with the issue; e.g. 'added concurrent therapy', 'prior therapy documented', etc.
date		0..1	dateTime	Date committed
author		0..1	Reference(Practitioner | PractitionerRole)	Who is committing?
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DetectedIssue.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
DetectedIssue.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
DetectedIssue.code	preferred	DetectedIssueCategory http://hl7.org/fhir/ValueSet/detectedissue-category from the FHIR Standard
DetectedIssue.severity	required	DetectedIssueSeverity http://hl7.org/fhir/ValueSet/detectedissue-severity|4.0.1 from the FHIR Standard
DetectedIssue.evidence.code	example	ManifestationAndSymptomCodes http://hl7.org/fhir/ValueSet/manifestation-or-symptom from the FHIR Standard
DetectedIssue.mitigation.action	preferred	DetectedIssueMitigationAction http://hl7.org/fhir/ValueSet/detectedissue-mitigation-action from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DetectedIssue	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DetectedIssue	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	error	DetectedIssue	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	error	DetectedIssue	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DetectedIssue	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from DetectedIssue

Summary

Mandatory: 1 element
Must-Support: 8 elements

Structures

This structure refers to these other structures:

• CPG Patient (http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-patient)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-instantiatesCaseFeature
• http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeatureType
• http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeaturePertinence

Differential View

This structure is derived from DetectedIssue

Name	Flags	Card.	Type	Description & Constraints
DetectedIssue		0..*	DetectedIssue	Clinical issue with action
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
instantiatesCaseFeature	S	0..1	canonical(CPG Case Feature Definition)	CPG Instantiates Case Feature Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-instantiatesCaseFeature
caseFeatureType	S	0..1	code	CPG Case Feature Type Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeatureType Binding: CPG Case Feature Type Value Set (required): Whether the case feature is asserted or inferred
caseFeaturePertinence	S	0..1	code	CPG Case Feature Pertinence Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeaturePertinence Binding: CPG Case Feature Pertinence Value Set (required): Describes the pertinence of a case feature
status	S	1..1	code	registered | preliminary | final | amended +
code		1..1	CodeableConcept	Issue Category, e.g. drug-drug, duplicate therapy, etc.
patient	S	0..1	Reference(CPG Patient)	Associated patient
evidence	S	0..*	BackboneElement	Supporting evidence
code	S	0..*	CodeableConcept	Manifestation
detail	S	0..*	Reference(Resource)	Supporting information
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
DetectedIssue		0..*	DetectedIssue	Clinical issue with action
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
instantiatesCaseFeature	S	0..1	canonical(CPG Case Feature Definition)	CPG Instantiates Case Feature Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-instantiatesCaseFeature
caseFeatureType	S	0..1	code	CPG Case Feature Type Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeatureType Binding: CPG Case Feature Type Value Set (required): Whether the case feature is asserted or inferred
caseFeaturePertinence	S	0..1	code	CPG Case Feature Pertinence Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeaturePertinence Binding: CPG Case Feature Pertinence Value Set (required): Describes the pertinence of a case feature
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Indicates the status of the identified issue.
code	Σ	1..1	CodeableConcept	Issue Category, e.g. drug-drug, duplicate therapy, etc. Binding: DetectedIssueCategory (preferred): Codes identifying the general type of detected issue; e.g. Drug-drug interaction, Timing issue, Duplicate therapy, etc.
patient	SΣ	0..1	Reference(CPG Patient)	Associated patient
evidence	S	0..*	BackboneElement	Supporting evidence
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..*	CodeableConcept	Manifestation Binding: ManifestationAndSymptomCodes (example): Codes that describes the types of evidence for a detected issue.
detail	S	0..*	Reference(Resource)	Supporting information
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DetectedIssue.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
DetectedIssue.code	preferred	DetectedIssueCategory http://hl7.org/fhir/ValueSet/detectedissue-category from the FHIR Standard
DetectedIssue.evidence.code	example	ManifestationAndSymptomCodes http://hl7.org/fhir/ValueSet/manifestation-or-symptom from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DetectedIssue	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DetectedIssue	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	error	DetectedIssue	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	error	DetectedIssue	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DetectedIssue	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
DetectedIssue		0..*	DetectedIssue	Clinical issue with action
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
instantiatesCaseFeature	S	0..1	canonical(CPG Case Feature Definition)	CPG Instantiates Case Feature Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-instantiatesCaseFeature
caseFeatureType	S	0..1	code	CPG Case Feature Type Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeatureType Binding: CPG Case Feature Type Value Set (required): Whether the case feature is asserted or inferred
caseFeaturePertinence	S	0..1	code	CPG Case Feature Pertinence Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeaturePertinence Binding: CPG Case Feature Pertinence Value Set (required): Describes the pertinence of a case feature
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Unique id for the detected issue
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Indicates the status of the identified issue.
code	Σ	1..1	CodeableConcept	Issue Category, e.g. drug-drug, duplicate therapy, etc. Binding: DetectedIssueCategory (preferred): Codes identifying the general type of detected issue; e.g. Drug-drug interaction, Timing issue, Duplicate therapy, etc.
severity	Σ	0..1	code	high | moderate | low Binding: DetectedIssueSeverity (required): Indicates the potential degree of impact of the identified issue on the patient.
patient	SΣ	0..1	Reference(CPG Patient)	Associated patient
identified[x]	Σ	0..1		When identified
identifiedDateTime			dateTime
identifiedPeriod			Period
author	Σ	0..1	Reference(Practitioner | PractitionerRole | Device)	The provider or device that identified the issue
implicated	Σ	0..*	Reference(Resource)	Problem resource
evidence	S	0..*	BackboneElement	Supporting evidence
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..*	CodeableConcept	Manifestation Binding: ManifestationAndSymptomCodes (example): Codes that describes the types of evidence for a detected issue.
detail	S	0..*	Reference(Resource)	Supporting information
detail		0..1	string	Description and context
reference		0..1	uri	Authority for issue
mitigation		0..*	BackboneElement	Step taken to address
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
action		1..1	CodeableConcept	What mitigation? Binding: DetectedIssueMitigationAction (preferred): Codes describing steps taken to resolve the issue or other circumstances that mitigate the risk associated with the issue; e.g. 'added concurrent therapy', 'prior therapy documented', etc.
date		0..1	dateTime	Date committed
author		0..1	Reference(Practitioner | PractitionerRole)	Who is committing?
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DetectedIssue.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
DetectedIssue.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
DetectedIssue.code	preferred	DetectedIssueCategory http://hl7.org/fhir/ValueSet/detectedissue-category from the FHIR Standard
DetectedIssue.severity	required	DetectedIssueSeverity http://hl7.org/fhir/ValueSet/detectedissue-severity|4.0.1 from the FHIR Standard
DetectedIssue.evidence.code	example	ManifestationAndSymptomCodes http://hl7.org/fhir/ValueSet/manifestation-or-symptom from the FHIR Standard
DetectedIssue.mitigation.action	preferred	DetectedIssueMitigationAction http://hl7.org/fhir/ValueSet/detectedissue-mitigation-action from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DetectedIssue	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DetectedIssue	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	error	DetectedIssue	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	error	DetectedIssue	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DetectedIssue	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from DetectedIssue

Summary

Mandatory: 1 element
Must-Support: 8 elements

Structures

This structure refers to these other structures:

• CPG Patient (http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-patient)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-instantiatesCaseFeature
• http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeatureType
• http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeaturePertinence

Other representations of profile: CSV, Excel, Schematron