profile-DetectedIssue
type: StructureDefinition
node role: treeRoot
id:
  v: profile-DetectedIssue
text:
  status:
    v: extensions
  div:
    v: Generated Narrative: StructureDefinition profile-DetectedIssue Name Flags Card. Type Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> DetectedIssue 0..* DetectedIssue(4.3.0) Clinical issue with action #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:category 0..* CodeableConcept R5: Type of detected issue, e.g. drug-drug, duplicate therapy, etc (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DetectedIssue.category Binding: DetectedIssueCategory (preferred): Codes for high level detected issue categories. #xD; extension:encounter 0..1 Reference(Cross-version Profile for R5.Encounter for use in FHIR R4B(0.1.0) | Encounter) R5: Encounter detected issue is part of (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DetectedIssue.encounter #xD; status #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:status 0..1 code R5: preliminary | final | entered-in-error | mitigated additional codes URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DetectedIssue.status Binding: R5DetectedissueStatusForR4BObservationStatus (0.1.0) (required): Indicates the status of the identified issue. #xD; patient #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:subject 0..1 Reference(Resource) R5: Associated subject URL: http://hl7.org/fhir/StructureDefinition/alternate-reference #xD; author #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:author 0..1 Reference(Resource) R5: author URL: http://hl7.org/fhir/StructureDefinition/alternate-reference #xD; mitigation #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:note 0..* Annotation R5: Additional notes about the mitigation (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DetectedIssue.mitigati…
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-wg
    l: structuredefinition-wg
  value: Code
    v: fhir
extension:
  extension:
    url:
      v: packageId
      l: packageId
    value: Id
      v: hl7.fhir.uv.xver-r5.r4b
  extension:
    url:
      v: version
      l: version
    value: String
      v: 0.1.0
  url:
    v: http://hl7.org/fhir/StructureDefinition/package-source
    l: package-source
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm
    l: structuredefinition-fmm
  value: Integer
    v: 0
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom
        l: structuredefinition-conformance-derivedFrom
      value: Canonical
        v: http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r5.r4b
        l: hl7.fhir.uv.xver-r5.r4b
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status
    l: structuredefinition-standards-status
  value: Code
    v: trial-use
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom
        l: structuredefinition-conformance-derivedFrom
      value: Canonical
        v: http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r5.r4b
        l: hl7.fhir.uv.xver-r5.r4b
url:
  v: http://hl7.org/fhir/5.0/StructureDefinition/profile-DetectedIssue
  l: profile-DetectedIssue
version:
  v: 0.1.0
name:
  v: Profile_R5_DetectedIssue_R4B
title:
  v: Cross-version Profile for R5.DetectedIssue for use in FHIR R4B
status:
  v: active
experimental:
  v: false
date:
  v: 2026-03-17T16:03:54.8045832-05:00
publisher:
  v: FHIR Infrastructure
contact:
  name:
    v: FHIR Infrastructure
  telecom:
    system:
      v: url
    value:
      v: http://www.hl7.org/Special/committees/fiwg
description:
  v: This cross-version profile allows R5 DetectedIssue content to be represented via FHIR R4B DetectedIssue resources.
jurisdiction:
  coding:
    system:
      v: http://unstats.un.org/unsd/methods/m49/m49.htm
      l: m49.htm
    code:
      v: 001
    display:
      v: World
fhir version:
  v: 4.3.0
mapping:
  identity:
    v: workflow
  uri:
    v: http://hl7.org/fhir/workflow
    l: workflow
  name:
    v: Workflow Pattern
mapping:
  identity:
    v: v2
  uri:
    v: http://hl7.org/v2
    l: v2
  name:
    v: HL7 v2 Mapping
mapping:
  identity:
    v: rim
  uri:
    v: http://hl7.org/v3
    l: v3
  name:
    v: RIM Mapping
mapping:
  identity:
    v: w5
  uri:
    v: http://hl7.org/fhir/fivews
    l: fivews
  name:
    v: FiveWs Pattern Mapping
kind:
  v: resource
abstract:
  v: false
type:
  v: DetectedIssue
  l: DetectedIssue
base definition:
  v: http://hl7.org/fhir/StructureDefinition/DetectedIssue|4.3.0
  l: http://hl7.org/fhir/StructureDefinition/DetectedIssue
derivation:
  v: constraint
snapshot:
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version
      l: snapshot-base-version
    value: String
      v: 4.3.0
  element:
    id:
      v: DetectedIssue
    path:
      v: DetectedIssue
    short:
      v: Clinical issue with action
    definition:
      v: Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, Ineffective treatment frequency, Procedure-condition conflict, etc.
    alias:
      v: DDI
    alias:
      v: drug-drug interaction
    alias:
      v: Contraindication
    alias:
      v: Alert
    min:
      v: 0
    max:
      v: *
    base:
      path:
        v: DetectedIssue
      min:
        v: 0
      max:
        v: *
    constraint:
      key:
        v: dom-2
      severity:
        v: error
      human:
        v: If the resource is contained in another resource, it SHALL NOT contain nested Resources
      expression:
        v: contained.contained.empty()
      xpath:
        v: not(parent::f:contained and f:contained)
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource|4.3.0
        l: http://hl7.org/fhir/StructureDefinition/DomainResource
    constraint:
      key:
        v: dom-3
      severity:
        v: error
      human:
        v: 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
      expression:
        v: contained.where(((id.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty()
      xpath:
        v: not(exists(for $contained in f:contained return $contained[not(exists(parent::*/descendant::f:reference/@value=concat('#', $contained/*/f:id/@value)) or exists(descendant::f:reference[@value='#']))]))
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource|4.3.0
        l: http://hl7.org/fhir/StructureDefinition/DomainResource

key:
  v: dom-4
severity:
  v: error
human:
  v: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
expression:
  v: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
xpath:
  v: not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
source:
  v: http://hl7.org/fhir/StructureDefinition/DomainResource|4.3.0
  l: http://hl7.org/fhir/StructureDefinition/DomainResource

key:
  v: dom-5
severity:
  v: error
human:
  v: If a resource is contained in another resource, it SHALL NOT have a security label
expression:
  v: contained.meta.security.empty()
xpath:
  v: not(exists(f:contained/*/f:meta/f:security))
source:
  v: http://hl7.org/fhir/StructureDefinition/DomainResource|4.3.0
  l: http://hl7.org/fhir/StructureDefinition/DomainResource

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice
    l: elementdefinition-bestpractice
  value: Boolean
    v: true
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation
    l: elementdefinition-bestpractice-explanation
  value: Markdown
    v: When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
key:
  v: dom-6
severity:
  v: warning
human:
  v: A resource should have narrative for robust management
expression:
  v: text.`div`.exists()
xpath:
  v: exists(f:text/h:div)
source:
  v: http://hl7.org/fhir/StructureDefinition/DomainResource|4.3.0
  l: http://hl7.org/fhir/StructureDefinition/DomainResource

v: false

v: false

v: false

identity:
  v: rim
map:
  v: Entity. Role, or Act

identity:
  v: workflow
map:
  v: Event

identity:
  v: v2
map:
  v: Partial mapping from messages containing the AL1 or IAM segment, such as the ADT^A01, ADT^A08, and ADT^A60.

identity:
  v: rim
map:
  v: Observation[classCode=ALRT, moodCode=EVN)

identity:
  v: w5
map:
  v: clinical.general

id:
  v: DetectedIssue.id
path:
  v: DetectedIssue.id
short:
  v: Logical id of this artifact
definition:
  v: The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
comment:
  v: The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: id
      l: id
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
must support:
  v: false
is modifier:
  v: false
is summary:
  v: true

id:
  v: DetectedIssue.meta
path:
  v: DetectedIssue.meta
short:
  v: Metadata about the resource
definition:
  v: 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.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.meta
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Meta
    l: Meta
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: true

id:
  v: DetectedIssue.implicitRules
path:
  v: DetectedIssue.implicitRules
short:
  v: A set of rules under which this content was created
definition:
  v: 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.
comment:
  v: 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.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.implicitRules
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: uri
    l: uri
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
must support:
  v: false
is modifier:
  v: true
is modifier reason:
  v: 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
is summary:
  v: true

id:
  v: DetectedIssue.language
path:
  v: DetectedIssue.language
short:
  v: Language of the resource content
definition:
  v: The base language in which the resource is written.
comment:
  v: 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).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.language
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet
      l: elementdefinition-maxValueSet
    value: Canonical
      v: http://hl7.org/fhir/ValueSet/all-languages|4.3.0
      l: http://hl7.org/fhir/ValueSet/all-languages
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: Language
  strength:
    v: preferred
  description:
    v: IETF language tag
  value set:
    v: http://hl7.org/fhir/ValueSet/languages|4.3.0
    l: http://hl7.org/fhir/ValueSet/languages

id:
  v: DetectedIssue.text
path:
  v: DetectedIssue.text
short:
  v: Text summary of the resource, for human interpretation
definition:
  v: 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.
comment:
  v: 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.
alias:
  v: narrative
alias:
  v: html
alias:
  v: xhtml
alias:
  v: display
min:
  v: 0
max:
  v: 1
base:
  path:
    v: DomainResource.text
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Narrative
    l: Narrative
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: Act.text?

id:
  v: DetectedIssue.contained
path:
  v: DetectedIssue.contained
short:
  v: Contained, inline Resources
definition:
  v: 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.
comment:
  v: 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.
alias:
  v: inline resources
alias:
  v: anonymous resources
alias:
  v: contained resources
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.contained
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Resource
    l: Resource
constraint:
  key:
    v: dom-r4b
  severity:
    v: warning
  human:
    v: Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems
  expression:
    v: ($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)
  xpath:
    v: not(f:Citation|f:Evidence|f:EvidenceReport|f:EvidenceVariable|f:MedicinalProductDefinition|f:PackagedProductDefinition|f:AdministrableProductDefinition|f:Ingredient|f:ClinicalUseDefinition|f:RegulatedAuthorization|f:SubstanceDefinition|f:SubscriptionStatus|f:SubscriptionTopic) or not(parent::f:Citation|parent::f:Evidence|parent::f:EvidenceReport|parent::f:EvidenceVariable|parent::f:MedicinalProductDefinition|parent::f:PackagedProductDefinition|parent::f:AdministrableProductDefinition|parent::f:Ingredient|parent::f:ClinicalUseDefinition|parent::f:RegulatedAuthorization|parent::f:SubstanceDefinition|f:SubscriptionStatus|f:SubscriptionTopic)
  source:
    v: http://hl7.org/fhir/StructureDefinition/DetectedIssue|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/DetectedIssue
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: DetectedIssue.extension
path:
  v: DetectedIssue.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  ordered:
    v: false
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Extension
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: DetectedIssue.extension:category
path:
  v: DetectedIssue.extension
slice name:
  v: category
short:
  v: R5: Type of detected issue, e.g. drug-drug, duplicate therapy, etc (new)
definition:
  v: R5: `DetectedIssue.category` (new:CodeableConcept)
comment:
  v: Element `DetectedIssue.category` has a context of DetectedIssue based on following the parent source element upwards and mapping to `DetectedIssue`. Element `DetectedIssue.category` has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element). In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
  profile:
    v: http://hl7.org/fhir/5.0/StructureDefinition/extension-DetectedIssue.category|0.1.0
    l: http://hl7.org/fhir/5.0/StructureDefinition/extension-DetectedIssue.category
condition:
  v: ele-1
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children unless an empty Parameters resource
  expression:
    v: hasValue() or (children().count() > id.count()) or $this is Parameters
  xpath:
    v: @value|f:*|h:div|self::f:Parameters
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Extension
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: DetectedIssue.extension:encounter
path:
  v: DetectedIssue.extension
slice name:
  v: encounter
short:
  v: R5: Encounter detected issue is part of (new)
definition:
  v: R5: `DetectedIssue.encounter` (new:Reference(Encounter))
comment:
  v: Element `DetectedIssue.encounter` has a context of DetectedIssue based on following the parent source element upwards and mapping to `DetectedIssue`. Element `DetectedIssue.encounter` has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element). This will typically be the encounter the DetectedIssue was created during, but some DetectedIssues may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission lab tests).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: DomainResource.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
  profile:
    v: http://hl7.org/fhir/5.0/StructureDefinition/extension-DetectedIssue.encounter|0.1.0
    l: http://hl7.org/fhir/5.0/StructureDefinition/extension-DetectedIssue.encounter
condition:
  v: ele-1
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children unless an empty Parameters resource
  expression:
    v: hasValue() or (children().count() > id.count()) or $this is Parameters
  xpath:
    v: @value|f:*|h:div|self::f:Parameters
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Extension
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: DetectedIssue.modifierExtension
path:
  v: DetectedIssue.modifierExtension
short:
  v: Extensions that cannot be ignored
definition:
  v: 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).
comment:
  v: 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.
requirements:
  v: 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](http://hl7.org/fhir/R4B/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Extension
must support:
  v: false
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: DetectedIssue.identifier
path:
  v: DetectedIssue.identifier
short:
  v: Unique id for the detected issue
definition:
  v: Business identifier associated with the detected issue record.
requirements:
  v: Allows linking instances of the same detected issue found on different servers.
min:
  v: 0
max:
  v: *
base:
  path:
    v: DetectedIssue.identifier
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Identifier
    l: Identifier
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Event.identifier
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.identifier
mapping:
  identity:
    v: v2
  map:
    v: IAM-7
mapping:
  identity:
    v: rim
  map:
    v: .id

id:
  v: DetectedIssue.status
path:
  v: DetectedIssue.status
short:
  v: registered | preliminary | final | amended +
definition:
  v: Indicates the status of the detected issue.
comment:
  v: This element is labeled as a modifier because the status contains the codes cancelled and entered-in-error that mark the issue as not currently valid.
alias:
  v: status
min:
  v: 1
max:
  v: 1
base:
  path:
    v: DetectedIssue.status
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
must support:
  v: false
is modifier:
  v: true
is modifier reason:
  v: This element is labeled 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
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: DetectedIssueStatus
  strength:
    v: required
  description:
    v: Indicates the status of the identified issue.
  value set:
    v: http://hl7.org/fhir/ValueSet/observation-status|4.3.0
    l: http://hl7.org/fhir/ValueSet/observation-status
mapping:
  identity:
    v: workflow
  map:
    v: Event.status
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.status

id:
  v: DetectedIssue.status.id
path:
  v: DetectedIssue.status.id
representation:
  v: xmlAttr
short:
  v: xml:id (or equivalent in JSON)
definition:
  v: unique id for the element within a resource (for internal references)
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false

id:
  v: DetectedIssue.status.extension
path:
  v: DetectedIssue.status.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  ordered:
    v: false
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: DetectedIssue.status.extension:status
path:
  v: DetectedIssue.status.extension
slice name:
  v: status
short:
  v: R5: preliminary | final | entered-in-error | mitigated additional codes
definition:
  v: R5: `DetectedIssue.status` additional codes
comment:
  v: Element `DetectedIssue.status` is mapped to FHIR R4B element `DetectedIssue.status` as `RelatedTo`. The mappings for `DetectedIssue.status` do not allow expression of the necessary codes, per the bindings on the source and target. The target context `DetectedIssue.status` is a modifier element, so this extension does not need to be defined as a modifier. This element is labeled as a modifier because the status contains the code entered-in-error that marks the issue as not currently valid.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
  profile:
    v: http://hl7.org/fhir/5.0/StructureDefinition/extension-DetectedIssue.status|0.1.0
    l: http://hl7.org/fhir/5.0/StructureDefinition/extension-DetectedIssue.status
condition:
  v: ele-1
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children unless an empty Parameters resource
  expression:
    v: hasValue() or (children().count() > id.count()) or $this is Parameters
  xpath:
    v: @value|f:*|h:div|self::f:Parameters
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: DetectedIssue.status.value
path:
  v: DetectedIssue.status.value
representation:
  v: xmlAttr
short:
  v: Primitive value for code
definition:
  v: Primitive value for code
min:
  v: 0
max:
  v: 1
base:
  path:
    v: string.value
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: code
      l: code
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/regex
      l: regex
    value: String
      v: [^\s]+(\s[^\s]+)*
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false

id:
  v: DetectedIssue.code
path:
  v: DetectedIssue.code
short:
  v: Issue Category, e.g. drug-drug, duplicate therapy, etc.
definition:
  v: Identifies the general type of issue identified.
alias:
  v: type
min:
  v: 0
max:
  v: 1
base:
  path:
    v: DetectedIssue.code
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: DetectedIssueCategory
  strength:
    v: preferred
  description:
    v: Codes identifying the general type of detected issue; e.g. Drug-drug interaction, Timing issue, Duplicate therapy, etc.
  value set:
    v: http://hl7.org/fhir/ValueSet/detectedissue-category|4.3.0
    l: http://hl7.org/fhir/ValueSet/detectedissue-category
mapping:
  identity:
    v: workflow
  map:
    v: Event.code
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.class
mapping:
  identity:
    v: v2
  map:
    v: AL1-2 / IAM-9
mapping:
  identity:
    v: rim
  map:
    v: .code

id:
  v: DetectedIssue.severity
path:
  v: DetectedIssue.severity
short:
  v: high | moderate | low
definition:
  v: Indicates the degree of importance associated with the identified issue based on the potential impact on the patient.
alias:
  v: severity
min:
  v: 0
max:
  v: 1
base:
  path:
    v: DetectedIssue.severity
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: DetectedIssueSeverity
  strength:
    v: required
  description:
    v: Indicates the potential degree of impact of the identified issue on the patient.
  value set:
    v: http://hl7.org/fhir/ValueSet/detectedissue-severity|4.3.0
    l: http://hl7.org/fhir/ValueSet/detectedissue-severity
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.grade
mapping:
  identity:
    v: v2
  map:
    v: AL1-4/ IAR-2
mapping:
  identity:
    v: rim
  map:
    v: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV].value

id:
  v: DetectedIssue.patient
path:
  v: DetectedIssue.patient
short:
  v: Associated patient
definition:
  v: Indicates the patient whose record the detected issue is associated with.
requirements:
  v: While the subject could be inferred by tracing the subject of the implicated resources, it's useful to have a direct link for query purposes.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: DetectedIssue.patient
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Patient|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Patient
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Event.subject
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.subject[x]
mapping:
  identity:
    v: v2
  map:
    v: PID-3
mapping:
  identity:
    v: rim
  map:
    v: .participation[typeCode=SBJ].role[classCode=PAT]
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.subject

id:
  v: DetectedIssue.patient.id
path:
  v: DetectedIssue.patient.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: id
      l: id
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: DetectedIssue.patient.extension
path:
  v: DetectedIssue.patient.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  ordered:
    v: false
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: DetectedIssue.patient.extension:subject
path:
  v: DetectedIssue.patient.extension
slice name:
  v: subject
short:
  v: R5: Associated subject
definition:
  v: R5: `DetectedIssue.subject`
comment:
  v: Element `DetectedIssue.subject` is mapped to FHIR R4B element `DetectedIssue.patient` as `SourceIsBroaderThanTarget`. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `DetectedIssue.subject` with unmapped reference targets: BiologicallyDerivedProduct, Device, Group, Location, Medication, NutritionProduct, Organization, Practitioner, Procedure, Substance.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
  profile:
    v: http://hl7.org/fhir/StructureDefinition/alternate-reference|5.2.0
    l: http://hl7.org/fhir/StructureDefinition/alternate-reference
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: DetectedIssue.patient.reference
path:
  v: DetectedIssue.patient.reference
short:
  v: Literal reference, Relative, internal or absolute URL
definition:
  v: A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
comment:
  v: Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Reference.reference
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
condition:
  v: ref-1
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: DetectedIssue.patient.type
path:
  v: DetectedIssue.patient.type
short:
  v: Type the reference refers to (e.g. "Patient")
definition:
  v: The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
comment:
  v: This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Reference.type
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: uri
    l: uri
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/build/StructureDefinition/binding-definition
      l: binding-definition
    value: String
      v: Aa resource (or, for logical models, the URI of the logical model).
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: FHIRResourceTypeExt
  strength:
    v: extensible
  value set:
    v: http://hl7.org/fhir/ValueSet/resource-types|4.3.0
    l: http://hl7.org/fhir/ValueSet/resource-types
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: DetectedIssue.patient.identifier
path:
  v: DetectedIssue.patient.identifier
short:
  v: Logical reference, when literal reference is not known
definition:
  v: An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
comment:
  v: When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Reference.identifier
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Identifier
    l: Identifier
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: .identifier

id:
  v: DetectedIssue.patient.display
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable
    l: elementdefinition-translatable
  value: Boolean
    v: true
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable
    l: elementdefinition-translatable
  value: Boolean
    v: true
path:
  v: DetectedIssue.patient.display
short:
  v: Text alternative for the resource
definition:
  v: Plain text narrative that identifies the resource in addition to the resource reference.
comment:
  v: This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Reference.display
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: DetectedIssue.identified[x]
path:
  v: DetectedIssue.identified[x]
short:
  v: When identified
definition:
  v: The date or period when the detected issue was initially identified.
requirements:
  v: No-one can be responsible for mitigation prior to the issue being identified.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: DetectedIssue.identified[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: dateTime
    l: dateTime
type:
  code:
    v: Period
    l: Period
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Event.occurrence[x]
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.recorded
mapping:
  identity:
    v: v2
  map:
    v: ALI-6 / IAM-11
mapping:
  identity:
    v: rim
  map:
    v: .effectiveTime

id:
  v: DetectedIssue.author
path:
  v: DetectedIssue.author
short:
  v: The provider or device that identified the issue
definition:
  v: Individual or device responsible for the issue being raised. For example, a decision support application or a pharmacist conducting a medication review.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: DetectedIssue.author
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Practitioner|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Practitioner
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/PractitionerRole
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Device|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Device
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Event.performer.actor
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.author
mapping:
  identity:
    v: v2
  map:
    v: IAM-14 / IAM-16
mapping:
  identity:
    v: rim
  map:
    v: .participation[typeCode=AUT].role[classCode=ASSIGNED]

id:
  v: DetectedIssue.author.id
path:
  v: DetectedIssue.author.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: id
      l: id
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: DetectedIssue.author.extension
path:
  v: DetectedIssue.author.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  ordered:
    v: false
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: DetectedIssue.author.extension:author
path:
  v: DetectedIssue.author.extension
slice name:
  v: author
short:
  v: R5: author
definition:
  v: R5: `DetectedIssue.author`
comment:
  v: Element `DetectedIssue.author` is mapped to FHIR R4B element `DetectedIssue.author` as `SourceIsBroaderThanTarget`. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `DetectedIssue.author` with unmapped reference targets: Patient, RelatedPerson.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
  profile:
    v: http://hl7.org/fhir/StructureDefinition/alternate-reference|5.2.0
    l: http://hl7.org/fhir/StructureDefinition/alternate-reference
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: DetectedIssue.author.reference
path:
  v: DetectedIssue.author.reference
short:
  v: Literal reference, Relative, internal or absolute URL
definition:
  v: A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
comment:
  v: Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Reference.reference
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
condition:
  v: ref-1
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: DetectedIssue.author.type
path:
  v: DetectedIssue.author.type
short:
  v: Type the reference refers to (e.g. "Patient")
definition:
  v: The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
comment:
  v: This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Reference.type
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: uri
    l: uri
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/build/StructureDefinition/binding-definition
      l: binding-definition
    value: String
      v: Aa resource (or, for logical models, the URI of the logical model).
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: FHIRResourceTypeExt
  strength:
    v: extensible
  value set:
    v: http://hl7.org/fhir/ValueSet/resource-types|4.3.0
    l: http://hl7.org/fhir/ValueSet/resource-types
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: DetectedIssue.author.identifier
path:
  v: DetectedIssue.author.identifier
short:
  v: Logical reference, when literal reference is not known
definition:
  v: An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
comment:
  v: When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Reference.identifier
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Identifier
    l: Identifier
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: .identifier

id:
  v: DetectedIssue.author.display
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable
    l: elementdefinition-translatable
  value: Boolean
    v: true
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable
    l: elementdefinition-translatable
  value: Boolean
    v: true
path:
  v: DetectedIssue.author.display
short:
  v: Text alternative for the resource
definition:
  v: Plain text narrative that identifies the resource in addition to the resource reference.
comment:
  v: This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Reference.display
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: DetectedIssue.implicated
path:
  v: DetectedIssue.implicated
short:
  v: Problem resource
definition:
  v: Indicates the resource representing the current activity or proposed activity that is potentially problematic.
comment:
  v: There's an implicit constraint on the number of implicated resources based on DetectedIssue.type; e.g. For drug-drug, there would be more than one. For timing, there would typically only be one.
alias:
  v: cause
min:
  v: 0
max:
  v: *
base:
  path:
    v: DetectedIssue.implicated
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Resource|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Resource
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Event.reasonReference
mapping:
  identity:
    v: rim
  map:
    v: .outboundRelationship[typeCode=SUBJ].target[moodCode=EVN, INT]

id:
  v: DetectedIssue.evidence
path:
  v: DetectedIssue.evidence
short:
  v: Supporting evidence
definition:
  v: Supporting evidence or manifestations that provide the basis for identifying the detected issue such as a GuidanceResponse or MeasureReport.
min:
  v: 0
max:
  v: *
base:
  path:
    v: DetectedIssue.evidence
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
    l: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children unless an empty Parameters resource
  expression:
    v: hasValue() or (children().count() > id.count()) or $this is Parameters
  xpath:
    v: @value|f:*|h:div|self::f:Parameters
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.why[x]

id:
  v: DetectedIssue.evidence.id
path:
  v: DetectedIssue.evidence.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
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    value: Url
      v: string
      l: string
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    v: http://hl7.org/fhirpath/System.String
    l: System.String
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  v: false
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mapping:
  identity:
    v: rim
  map:
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id:
  v: DetectedIssue.evidence.extension
path:
  v: DetectedIssue.evidence.extension
short:
  v: Additional content defined by implementations
definition:
  v: 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.
comment:
  v: 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.
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  v: extensions
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  v: user content
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  code:
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    l: Extension
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    v: ele-1
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    v: error
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    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
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    v: @value|f:*|h:div
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    v: http://hl7.org/fhir/StructureDefinition/Element|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Element
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  key:
    v: ext-1
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    v: error
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    v: Must have either extensions or value[x], not both
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  map:
    v: n/a

id:
  v: DetectedIssue.evidence.modifierExtension
path:
  v: DetectedIssue.evidence.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: 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).
comment:
  v: 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.
requirements:
  v: 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](http://hl7.org/fhir/R4B/extensibility.html#modifierExtension).
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  v: user content
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  v: true
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  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
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  v: true
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  identity:
    v: rim
  map:
    v: N/A

id:
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  v: DetectedIssue.evidence.code
short:
  v: Manifestation
definition:
  v: A manifestation that led to the recording of this detected issue.
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  v: false
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    value: String
      v: DetectedIssueEvidenceCode
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    v: example
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    v: Codes that describes the types of evidence for a detected issue.
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    v: http://hl7.org/fhir/ValueSet/manifestation-or-symptom|4.3.0
    l: http://hl7.org/fhir/ValueSet/manifestation-or-symptom
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  map:
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id:
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    v: ele-1
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    v: error
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id:
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  v: DetectedIssue.detail
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  v: Description and context
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  v: Should focus on information not covered elsewhere as discrete data - no need to duplicate the narrative.
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mapping:
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    v: Event.note
mapping:
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    v: v2
  map:
    v: AL1-5 / IAM-8
mapping:
  identity:
    v: rim
  map:
    v: .text

id:
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  v: Authority for issue
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  v: false
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  v: false
mapping:
  identity:
    v: rim
  map:
    v: .outboundRelationship[typeCode=INST].target[classCode=ALRT, moodCode=DEFN].text.uri

id:
  v: DetectedIssue.mitigation
path:
  v: DetectedIssue.mitigation
short:
  v: Step taken to address
definition:
  v: Indicates an action that has been taken or is committed to reduce or eliminate the likelihood of the risk identified by the detected issue from manifesting. Can also reflect an observation of known mitigating factors that may reduce/eliminate the need for any action.
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    v: All FHIR elements must have a @value or children unless an empty Parameters resource
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  v: false
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    v: .outboundRelationship[typeCode=MITG].target[classCode=ACT, moodCode=EVN]

id:
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path:
  v: DetectedIssue.mitigation.id
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  v: Unique id for inter-element referencing
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  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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      l: string
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id:
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    type:
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definition:
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id:
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path:
  v: DetectedIssue.mitigation.extension
slice name:
  v: note
short:
  v: R5: Additional notes about the mitigation (new)
definition:
  v: R5: `DetectedIssue.mitigation.note` (new:Annotation)
comment:
  v: Element `DetectedIssue.mitigation.note` has a context of DetectedIssue.mitigation based on following the parent source element upwards and mapping to `DetectedIssue`. Element `DetectedIssue.mitigation.note` has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).
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    l: http://hl7.org/fhir/5.0/StructureDefinition/extension-DetectedIssue.mitigation.note
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    v: ele-1
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    v: error
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    v: All FHIR elements must have a @value or children unless an empty Parameters resource
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  v: false
is summary:
  v: false

id:
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path:
  v: DetectedIssue.mitigation.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: 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).
comment:
  v: 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.
requirements:
  v: 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](http://hl7.org/fhir/R4B/extensibility.html#modifierExtension).
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  v: user content
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    v: ele-1
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    v: All FHIR elements must have a @value or children
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    l: http://hl7.org/fhir/StructureDefinition/Element
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    v: ext-1
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    v: error
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    v: Must have either extensions or value[x], not both
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  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: DetectedIssue.mitigation.action
path:
  v: DetectedIssue.mitigation.action
short:
  v: What mitigation?
definition:
  v: Describes the action that was taken or the observation that was made that reduces/eliminates the risk associated with the identified issue.
comment:
  v: The "text" component can be used for detail or when no appropriate code exists.
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  v: 1
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type:
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    v: All FHIR elements must have a @value or children
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    l: http://hl7.org/fhir/StructureDefinition/Element
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  v: false
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  v: false
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  v: false
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  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: DetectedIssueMitigationAction
  strength:
    v: preferred
  description:
    v: 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.
  value set:
    v: http://hl7.org/fhir/ValueSet/detectedissue-mitigation-action|4.3.0
    l: http://hl7.org/fhir/ValueSet/detectedissue-mitigation-action
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    v: rim
  map:
    v: .code

id:
  v: DetectedIssue.mitigation.date
path:
  v: DetectedIssue.mitigation.date
short:
  v: Date committed
definition:
  v: Indicates when the mitigating action was documented.
comment:
  v: This might not be the same as when the mitigating step was actually taken.
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  v: 1
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    v: 1
type:
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    l: dateTime
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  key:
    v: ele-1
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    v: error
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    v: All FHIR elements must have a @value or children
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    v: hasValue() or (children().count() > id.count())
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  v: false
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  v: false
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  v: false
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  identity:
    v: rim
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    v: .effectiveTime

id:
  v: DetectedIssue.mitigation.author
path:
  v: DetectedIssue.mitigation.author
short:
  v: Who is committing?
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  v: Identifies the practitioner who determined the mitigation and takes responsibility for the mitigation step occurring.
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type:
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    v: http://hl7.org/fhir/StructureDefinition/Practitioner|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/Practitioner
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.3.0
    l: http://hl7.org/fhir/StructureDefinition/PractitionerRole
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  key:
    v: ele-1
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    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
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    v: rim
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    v: .participation[typeCode=AUT].role[classCode=ASSIGNED]

element:
  id:
    v: DetectedIssue
  path:
    v: DetectedIssue
element:
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    v: DetectedIssue.extension
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    v: DetectedIssue.extension
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    v: DetectedIssue.extension
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    v: category
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    v: R5: Type of detected issue, e.g. drug-drug, duplicate therapy, etc (new)
  definition:
    v: R5: `DetectedIssue.category` (new:CodeableConcept)
  comment:
    v: Element `DetectedIssue.category` has a context of DetectedIssue based on following the parent source element upwards and mapping to `DetectedIssue`. Element `DetectedIssue.category` has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element). In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.
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    v: *
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      l: Extension
    profile:
      v: http://hl7.org/fhir/5.0/StructureDefinition/extension-DetectedIssue.category|0.1.0
      l: http://hl7.org/fhir/5.0/StructureDefinition/extension-DetectedIssue.category
element:
  id:
    v: DetectedIssue.extension:encounter
  path:
    v: DetectedIssue.extension
  slice name:
    v: encounter
  short:
    v: R5: Encounter detected issue is part of (new)
  definition:
    v: R5: `DetectedIssue.encounter` (new:Reference(Encounter))
  comment:
    v: Element `DetectedIssue.encounter` has a context of DetectedIssue based on following the parent source element upwards and mapping to `DetectedIssue`. Element `DetectedIssue.encounter` has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element). This will typically be the encounter the DetectedIssue was created during, but some DetectedIssues may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission lab tests).
  min:
    v: 0
  max:
    v: 1
  base:
    path:
      v: DomainResource.extension
    min:
      v: 0
    max:
      v: *
  type:
    code:
      v: Extension
      l: Extension
    profile:
      v: http://hl7.org/fhir/5.0/StructureDefinition/extension-DetectedIssue.encounter|0.1.0
      l: http://hl7.org/fhir/5.0/StructureDefinition/extension-DetectedIssue.encounter
element:
  id:
    v: DetectedIssue.status.extension
  path:
    v: DetectedIssue.status.extension
  slicing:
    discriminator:
      type:
        v: value
      path:
        v: url
    ordered:
      v: false
    rules:
      v: open
  min:
    v: 0
  max:
    v: *
element:
  id:
    v: DetectedIssue.status.extension:status
  path:
    v: DetectedIssue.status.extension
  slice name:
    v: status
  short:
    v: R5: preliminary | final | entered-in-error | mitigated additional codes
  definition:
    v: R5: `DetectedIssue.status` additional codes
  comment:
    v: Element `DetectedIssue.status` is mapped to FHIR R4B element `DetectedIssue.status` as `RelatedTo`. The mappings for `DetectedIssue.status` do not allow expression of the necessary codes, per the bindings on the source and target. The target context `DetectedIssue.status` is a modifier element, so this extension does not need to be defined as a modifier. This element is labeled as a modifier because the status contains the code entered-in-error that marks the issue as not currently valid.
  min:
    v: 0
  max:
    v: 1
  base:
    path:
      v: DomainResource.extension
    min:
      v: 0
    max:
      v: *
  type:
    code:
      v: Extension
      l: Extension
    profile:
      v: http://hl7.org/fhir/5.0/StructureDefinition/extension-DetectedIssue.status|0.1.0
      l: http://hl7.org/fhir/5.0/StructureDefinition/extension-DetectedIssue.status
element:
  id:
    v: DetectedIssue.patient.extension
  path:
    v: DetectedIssue.patient.extension
  slicing:
    discriminator:
      type:
        v: value
      path:
        v: url
    ordered:
      v: false
    rules:
      v: open
  min:
    v: 0
  max:
    v: *
element:
  id:
    v: DetectedIssue.patient.extension:subject
  path:
    v: DetectedIssue.patient.extension
  slice name:
    v: subject
  short:
    v: R5: Associated subject
  definition:
    v: R5: `DetectedIssue.subject`
  comment:
    v: Element `DetectedIssue.subject` is mapped to FHIR R4B element `DetectedIssue.patient` as `SourceIsBroaderThanTarget`. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `DetectedIssue.subject` with unmapped reference targets: BiologicallyDerivedProduct, Device, Group, Location, Medication, NutritionProduct, Organization, Practitioner, Procedure, Substance.
  min:
    v: 0
  max:
    v: 1
  base:
    path:
      v: DomainResource.extension
    min:
      v: 0
    max:
      v: *
  type:
    code:
      v: Extension
      l: Extension
    profile:
      v: http://hl7.org/fhir/StructureDefinition/alternate-reference|5.2.0
      l: http://hl7.org/fhir/StructureDefinition/alternate-reference
element:
  id:
    v: DetectedIssue.author.extension
  path:
    v: DetectedIssue.author.extension
  slicing:
    discriminator:
      type:
        v: value
      path:
        v: url
    ordered:
      v: false
    rules:
      v: open

v: 0

v: *

id:
  v: DetectedIssue.author.extension:author
path:
  v: DetectedIssue.author.extension
slice name:
  v: author
short:
  v: R5: author
definition:
  v: R5: `DetectedIssue.author`
comment:
  v: Element `DetectedIssue.author` is mapped to FHIR R4B element `DetectedIssue.author` as `SourceIsBroaderThanTarget`. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `DetectedIssue.author` with unmapped reference targets: Patient, RelatedPerson.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: DomainResource.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
  profile:
    v: http://hl7.org/fhir/StructureDefinition/alternate-reference|5.2.0
    l: http://hl7.org/fhir/StructureDefinition/alternate-reference

id:
  v: DetectedIssue.mitigation.extension
path:
  v: DetectedIssue.mitigation.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  ordered:
    v: false
  rules:
    v: open
min:
  v: 0
max:
  v: *

id:
  v: DetectedIssue.mitigation.extension:note
path:
  v: DetectedIssue.mitigation.extension
slice name:
  v: note
short:
  v: R5: Additional notes about the mitigation (new)
definition:
  v: R5: `DetectedIssue.mitigation.note` (new:Annotation)
comment:
  v: Element `DetectedIssue.mitigation.note` has a context of DetectedIssue.mitigation based on following the parent source element upwards and mapping to `DetectedIssue`. Element `DetectedIssue.mitigation.note` has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
  profile:
    v: http://hl7.org/fhir/5.0/StructureDefinition/extension-DetectedIssue.mitigation.note|0.1.0
    l: http://hl7.org/fhir/5.0/StructureDefinition/extension-DetectedIssue.mitigation.note