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.

Business identifier associated with the detected issue record.

Allows linking instances of the same detected issue found on different servers.

Indicates the status of the detected issue.

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.

Identifies the general type of issue identified.

Indicates the degree of importance associated with the identified issue based on the potential impact on the patient.

Indicates the patient whose record the detected issue is associated with.

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.

The date or period when the detected issue was initially identified.

No-one can be responsible for mitigation prior to the issue being identified.

Individual or device responsible for the issue being raised. For example, a decision support application or a pharmacist conducting a medication review.

Indicates the resource representing the current activity or proposed activity that is potentially problematic.

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.

Supporting evidence or manifestations that provide the basis for identifying the detected issue such as a GuidanceResponse or MeasureReport.

A manifestation that led to the recording of this detected issue.

Links to resources that constitute evidence for the detected issue such as a GuidanceResponse or MeasureReport.

A textual explanation of the detected issue.

Should focus on information not covered elsewhere as discrete data - no need to duplicate the narrative.

The literature, knowledge-base or similar reference that describes the propensity for the detected issue identified.

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.

Describes the action that was taken or the observation that was made that reduces/eliminates the risk associated with the identified issue.

The "text" component can be used for detail or when no appropriate code exists.

Indicates when the mitigating action was documented.

This might not be the same as when the mitigating step was actually taken.

Identifies the practitioner who determined the mitigation and takes responsibility for the mitigation step occurring.