HL7 FHIR® Implementation Guide: Breast Cancer Data, Release 1 - US Realm (Draft for Comment)

This page is part of the Breast Cancer Data Logical Models and FHIR Profiles (v0.1.0: STU 1 Draft) based on FHIR R3. . For a full list of available versions, see the Directory of published versions

CompoundClinicalStatementModel

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  "resourceType" : "StructureDefinition",
  "id" : "cimi-CompoundClinicalStatement-model",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns="http://www.w3.org/1999/xhtml">
  <p><b>BC CompoundClinicalStatement Logical Model</b></p>
  <p>A CompoundClinicalStatement is a clinical statement representing a collection of independent clinical statements.

Each statement within a compound clinical statement may exist outside of the context of the compound clinical statement without any alteration to its meaning. An example is a Panel. Note that complex medications are indivisible clinical statements even though their structure may be a composite data structure. They are generally treated as an independent entry in a record and their parts do not constitute independent entries in a record.</p>
</div>"
  },
  "url" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-CompoundClinicalStatement-model",
  "identifier" : [
    {
      "system" : "http://hl7.org/fhir/us/breastcancer",
      "value" : "cimi.CompoundClinicalStatement"
    }
  ],
  "version" : "0.1.0",
  "name" : "CompoundClinicalStatementModel",
  "title" : "BC CompoundClinicalStatement Logical Model",
  "status" : "draft",
  "date" : "2018-04-01T00:00:00+11:00",
  "publisher" : "The HL7 Cancer Interoperability Group sponsored by Clinical Interoperability Council Work Group (CIC)",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://standardhealthrecord.org"
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  "description" : "A CompoundClinicalStatement is a clinical statement representing a collection of independent clinical statements.

Each statement within a compound clinical statement may exist outside of the context of the compound clinical statement without any alteration to its meaning. An example is a Panel. Note that complex medications are indivisible clinical statements even though their structure may be a composite data structure. They are generally treated as an independent entry in a record and their parts do not constitute independent entries in a record.",
  "kind" : "logical",
  "abstract" : false,
  "type" : "cimi-CompoundClinicalStatement-model",
  "baseDefinition" : "http://hl7.org/fhir/StructureDefinition/Element",
  "derivation" : "specialization",
  "snapshot" : {
    "element" : [
      {
        "id" : "cimi-CompoundClinicalStatement-model",
        "path" : "cimi-CompoundClinicalStatement-model",
        "definition" : "A CompoundClinicalStatement is a clinical statement representing a collection of independent clinical statements.

Each statement within a compound clinical statement may exist outside of the context of the compound clinical statement without any alteration to its meaning. An example is a Panel. Note that complex medications are indivisible clinical statements even though their structure may be a composite data structure. They are generally treated as an independent entry in a record and their parts do not constitute independent entries in a record.",
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      {
        "id" : "cimi-CompoundClinicalStatement-model.statementTopic",
        "path" : "cimi-CompoundClinicalStatement-model.statementTopic",
        "short" : "Compositional and reusable grouping of clinical statement attributes that make up the clinical focus of a statement.",
        "definition" : "Compositional and reusable grouping of clinical statement attributes that make up the clinical focus of a statement.

StatementTopic class attributes are aligned with SNOMED CT Concept Model attributes when such an overlap exists. Note that this class does not include contextual attributes such as the nature of the action (ordered, proposed, planned, etc...), the nature of the patient state being described (e.g., present, suspected present, absent), and the attribution of this information (the who, when, where, how, why of the information recorded).

CIMI Alignment: StatementTopic had an attribute called 'key' in CIMI V0.0.4, but CIMI is renaming it 'TopicCode', as represented here.",
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        "type" : [
          {
            "code" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-StatementTopic-model"
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      {
        "id" : "cimi-CompoundClinicalStatement-model.statementContext",
        "path" : "cimi-CompoundClinicalStatement-model.statementContext",
        "short" : "Compositional and reusable grouping of clinical statement attributes that provides the context for the topic of a clinical statement.",
        "definition" : "Compositional and reusable grouping of clinical statement attributes that provides the context for the topic of a clinical statement.

The StatementContext class aligns with the SNOMED CT Situations with Explicit Context (SWEC) Concept Model. The StatementContext provides the expressivity required to specify that an act was performed or not performed or that a finding was asserted to be present or absent for the given subject of information. It also often holds provenance information relevant to the context of the clinical statement. It is important to note that by default the context applies to the conjunction of the attribute specified in the statement. For instance, if a clinical statement has a topic describing a rash on left arm and a context of 'absent', then the statement states that the subject of interest did not have a rash on the left arm but might have had one on the right arm.

CIMI Alignment: ContextCode is the new CIMI name for the attribute formerly called 'type' in CIMI V0.0.4. The attribute 'temporalContext' that appeared in CIMI V0.0.4 is no longer part of CIMI.",
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        "id" : "cimi-CompoundClinicalStatement-model.encounter",
        "path" : "cimi-CompoundClinicalStatement-model.encounter",
        "short" : "An abstract class that represents an encounter class. This class has been stubbed out to limit the scope of this implementation guide to classes relevant to this ballot concerning breast cancer.",
        "definition" : "An abstract class that represents an encounter class. This class has been stubbed out to limit the scope of this implementation guide to classes relevant to this ballot concerning breast cancer.",
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      {
        "id" : "cimi-CompoundClinicalStatement-model.clinicalStatement",
        "path" : "cimi-CompoundClinicalStatement-model.clinicalStatement",
        "short" : "A special type of information entry consisting of a topic and a context.",
        "definition" : "A special type of information entry consisting of a topic and a context.

The ClinicalStatement class provides the core pattern for more specific clinical statement classes, such as a statement that a finding has been found in a patient or that a procedure has been proposed by a clinical decision support system. The ClinicalStatement pattern defines the core attributes common to most clinical statements and specifies a composition pattern that encourage model component reuse and better alignment with the SNOMED CT Concept Model. A clinical statement is composed of the StatementTopic class (grouping of attributes for capturing information about a procedure or a clinical finding) and the StatementContext class (grouping of attributes providing the context for the statement topic such as whether a procedure was performed, requested, not performed or whether a finding is suspected present or absent in the patient). At the archetype level, the topic and context components are coordinated to form the clinical statement. For instance, the composition of the ProcedureTopic with the NotPerformed context indicates that the given procedure was not performed.",
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  "differential" : {
    "element" : [
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        "definition" : "A CompoundClinicalStatement is a clinical statement representing a collection of independent clinical statements.

Each statement within a compound clinical statement may exist outside of the context of the compound clinical statement without any alteration to its meaning. An example is a Panel. Note that complex medications are indivisible clinical statements even though their structure may be a composite data structure. They are generally treated as an independent entry in a record and their parts do not constitute independent entries in a record.",
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      {
        "id" : "cimi-CompoundClinicalStatement-model.statementTopic",
        "path" : "cimi-CompoundClinicalStatement-model.statementTopic",
        "short" : "Compositional and reusable grouping of clinical statement attributes that make up the clinical focus of a statement.",
        "definition" : "Compositional and reusable grouping of clinical statement attributes that make up the clinical focus of a statement.

StatementTopic class attributes are aligned with SNOMED CT Concept Model attributes when such an overlap exists. Note that this class does not include contextual attributes such as the nature of the action (ordered, proposed, planned, etc...), the nature of the patient state being described (e.g., present, suspected present, absent), and the attribution of this information (the who, when, where, how, why of the information recorded).

CIMI Alignment: StatementTopic had an attribute called 'key' in CIMI V0.0.4, but CIMI is renaming it 'TopicCode', as represented here.",
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      {
        "id" : "cimi-CompoundClinicalStatement-model.statementContext",
        "path" : "cimi-CompoundClinicalStatement-model.statementContext",
        "short" : "Compositional and reusable grouping of clinical statement attributes that provides the context for the topic of a clinical statement.",
        "definition" : "Compositional and reusable grouping of clinical statement attributes that provides the context for the topic of a clinical statement.

The StatementContext class aligns with the SNOMED CT Situations with Explicit Context (SWEC) Concept Model. The StatementContext provides the expressivity required to specify that an act was performed or not performed or that a finding was asserted to be present or absent for the given subject of information. It also often holds provenance information relevant to the context of the clinical statement. It is important to note that by default the context applies to the conjunction of the attribute specified in the statement. For instance, if a clinical statement has a topic describing a rash on left arm and a context of 'absent', then the statement states that the subject of interest did not have a rash on the left arm but might have had one on the right arm.

CIMI Alignment: ContextCode is the new CIMI name for the attribute formerly called 'type' in CIMI V0.0.4. The attribute 'temporalContext' that appeared in CIMI V0.0.4 is no longer part of CIMI.",
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        "short" : "An abstract class that represents an encounter class. This class has been stubbed out to limit the scope of this implementation guide to classes relevant to this ballot concerning breast cancer.",
        "definition" : "An abstract class that represents an encounter class. This class has been stubbed out to limit the scope of this implementation guide to classes relevant to this ballot concerning breast cancer.",
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        "path" : "cimi-CompoundClinicalStatement-model.clinicalStatement",
        "short" : "A special type of information entry consisting of a topic and a context.",
        "definition" : "A special type of information entry consisting of a topic and a context.

The ClinicalStatement class provides the core pattern for more specific clinical statement classes, such as a statement that a finding has been found in a patient or that a procedure has been proposed by a clinical decision support system. The ClinicalStatement pattern defines the core attributes common to most clinical statements and specifies a composition pattern that encourage model component reuse and better alignment with the SNOMED CT Concept Model. A clinical statement is composed of the StatementTopic class (grouping of attributes for capturing information about a procedure or a clinical finding) and the StatementContext class (grouping of attributes providing the context for the statement topic such as whether a procedure was performed, requested, not performed or whether a finding is suspected present or absent in the patient). At the archetype level, the topic and context components are coordinated to form the clinical statement. For instance, the composition of the ProcedureTopic with the NotPerformed context indicates that the given procedure was not performed.",
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}