This page is part of the Medicolegal Death Investigation (MDI) (v1.1.0: STU 1) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Change Log

MDI STU 1.1 (September 2023)

Overall

• Updated and clarified data element descriptions to indicate roles of the “death certifier” FHIR-41184
• Clarified language, updating terms such as “MDI system” to “MDI case management system (MDI CMS)” for the electronic data systems FHIR-36944, FHIR-41685

Profiles

Capability Statements:

• Changed name/title of “CapabilityStatement - Medical Examiner/Coroner Server” to “CapabilityStatement - MDI CMS Server” FHIR-36944
• Added rest definitions to CapabilityStatement - MDI CMS Server and to CapabilityStatement - Electronic Death Reporting System (EDRS) Server FHIR-41518
• Added text to CapabilityStatement - MDI CMS Server, CapabilityStatement - Electronic Death Reporting System (EDRS) Server, and CapabilityStatement - Forensic Toxicology Laboratory Server for more informative html rendering of each resource FHIR-41515

Bundle - Document MDI to EDRS:

• Changed profile name/title to “Bundle - Document MDI and EDRS” FHIR-41684

Composition - MDI to EDRS:

• Changed profile name/title to “Composition - MDI and EDRS” FHIR-41684
• Made identifier optional FHIR-39411, FHIR-39412, FHIR-39413
• Changed the author from (1..*) to (1..1) and updated the description and definition FHIR-41347
• Removed the data-absent-reason extension from the attester and updated the description and definition FHIR-41347
• Added guidance to Composition.section: if no information for a required section, use Composition.section:cause-manner.emptyReason. FHIR-40691
• Changed cardinality from (0..*) to (0..1) for entry:other-condition, entry:manner, entry:how-injury FHIR-40691
• Updated entry:cause to “Up to 4 lines of cause of death” FHIR-40691
• Added a slice to section:exam-autopsy.entry for autopsy location FHIR-39414
• Corrected cardinality of Composition.section:narratives.code from 0..1 to 1..1 FHIR-41871

Observation - Cause of Death Part 1:

• Updated to align with Vital Records Death Reporting (VRDR) STU2, v.2.1.0 value(x) structure & lineNumber.valueInteger FHIR-41185
• Added valueQuantity and valueString options for interval.value(x) FHIR-41185
• Fixed the interval component to correctly display value[x] options on all 3 tabs (Differential, Key Elements, and Snapshot) FHIR-41643
• Improved Observation.component:interval.value[x] description to inform and guide users that the Quantity is only to be used for an amount of time FHIR-41643

Observation - Contributing Cause of Death Part 2: Updated to align with Vital Records Death Reporting (VRDR) STU2, v.2.1.0 performer cardinality, changed from (1..1) to (0..*) FHIR-41185

Observation - Death Date:

• Added choice of dateTime or period to Observation.value(x) FHIR-40470
• Added time to dateTime as choices for datetimePronouncedDead.value(x) to align with VRDR FHIR-40470
• Updated Observation.value[x].extension:partialDateTime to reference http://hl7.org/fhir/us/vrdr/StructureDefinition/PartialDateTime and updated short description FHIR-41647

Observation - How Death Injury Occurred: Updated Observation.value[x].extension:partialDateTime to reference http://hl7.org/fhir/us/vrdr/StructureDefinition/PartialDateTime and updated short description FHIR-41647

Observation - Autopsy Performed Indicator: Constrained performer to US Core Practitioner Profile FHIR-41346

Observation - Tobacco Use Contributed to Death: Updated to align with Vital Records Death Reporting (VRDR) STU2, v.2.1.0 code display FHIR-41185

Bundle - Message Toxicology to MDI: made identifier optional FHIR-39413

DocumentReference - MDI Report: Added profile of US Core DocumentReference Profile for exchange of death investigation documents, such as Autopsy Reports and Investigator’s Narratives. FHIR-41348

Extensions

• Removed Extension structure definitions: Extension-partial-date-time, Extension-date-year, Extension-date-month, Extension-date-day, and Extension-date-time; replaced uses with reference (url) to Vital Records Death Reporting (VRDR) extensions, thus creating a formal dependence on VRDR) FHIR-41647

Terminology

• Updated code displays to match source code systems (e.g., SNOMED CT)
• Removed unused valuesets: ValueSet - Units of Age; ValueSet - Yes, No, Not Applicable

Narrative Pages

Overall: Clarified language , updating terms such as “MDI system” to “MDI case management system (MDI CMS)” for the electronic data systems FHIR-36944

Best Practice: Updated guidance on absent data FHIR-41347

Security Recommendations: New page added and corrected information FHIR-41642

Terminology: Updated text to clarify similarities with VRDR FHIR-41519

Change Log: New page added FHIR-41184

Artifact Index:

• Moved MessageDefinition – Toxicology System to Toxicology Profiles grouping FHIR-41516
• Created new grouping, Administrative Profiles, for DocumentReference - MDI Report FHIR-41348

Examples:

• Updated “MDI and EDRS Composition - Freeman” example file to show death certifier roles FHIR-41184
• Added “MDI and EDRS Composition - draft” example file with author and attester not yet named (using the data-absent-reason). FHIR-41347
• Added “Observation - Cause of Death Part 1 - Freeman - quantity interval” example file
• Added “Observation - Death Date - period” and “Observation - Death Date - partial date” example files
• Added “Location - Death - Freeman address string” and “Location - Death - Lat/Long” example files
• Removed “US Core Practitioner - Dr. Jane Jones” example file and added “US Core Practitioner - Dr. J.M. Lehz” example file
• Added “DocumentReference - MDI Report - Autopsy Report” and “DocumentReference - MDI Report - Investigator’s Narrative” example files