2nd DSTU Draft For Comment

This page is part of the FHIR Specification (v0.4.0: DSTU 2 Draft). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions

4.11.8 Resource Contraindication - Detailed Descriptions

Detailed Descriptions for the elements in the Contraindication resource.

Contraindication
Definition

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.

Control1..1
Alternate NamesDDI; drug-drug interaction; DetectedIssue; Alert
Contraindication.patient
Definition

Indicates the patient whose record the contraindication is associated with.

Control0..1
TypeReference(Patient)
Requirements

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.

Summarytrue
Contraindication.category
Definition

Identifies the general type of issue identified.

Control0..1
BindingContraindicationCategory: Preferred: See http://hl7.org/fhir/vs/contraindication-category (Codes identifying the general type of contraindication. E.g. Drug-drug interaction, Timing issue, Duplicate therapy, etc.)
TypeCodeableConcept
Alternate Namestype
Summarytrue
Contraindication.severity
Definition

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

Control0..1
BindingContraindicationSeverity: Indicates the potential degree of impact of the identified issue on the patient (Required)
Typecode
Alternate Namesseverity
Summarytrue
Contraindication.implicated
Definition

Indicates the resource representing the current activity or proposed activity that.

Control0..*
TypeReference(Any)
Alternate Namescause
Summarytrue
Comments

There's an implicit constraint on the number of implicated resources based on Contraindication.type. E.g. For drug-drug, there would be more than one. For timing, there would typically only be one.

Contraindication.detail
Definition

A textual explanation of the contraindication.

Control0..1
Typestring
Comments

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

Contraindication.date
Definition

The date or date-time when the contraindication was initially identified.

Control0..1
TypedateTime
Requirements

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

Summarytrue
Contraindication.author
Definition

Identifies the provider or software that identified the.

Control0..1
TypeReference(Practitioner | Device)
Summarytrue
To DoIs this 80%?.
Contraindication.identifier
Definition

Business identifier associated with the contraindication record.

Control0..1
TypeIdentifier
Requirements

Allows linking instances of the same contraindication found on different servers.

Summarytrue
Contraindication.reference
Definition

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

Control0..1
Typeuri
To DoIs this in the 80%?.
Contraindication.mitigation
Definition

Indicates an action that has been taken or is committed to to reduce or eliminate the likelihood of the risk identified by the contraindicaiton from manifesting. Can also reflect an observation of known mitigating factors that may reduce/eliminate the need for any action.

Control0..*
To DoHow much, if any of this is in the 80%?.
Contraindication.mitigation.action
Definition

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

Control1..1
BindingContraindicationMitigationAction: Preferred: See http://hl7.org/fhir/vs/contraindication-mitigation-action (Codes describing steps taken to resolve the contraindication or other circumstances that mitigate the risk associated with the contraindication. E.g. 'added concurrent therapy', 'prior therapy documented', etc.)
TypeCodeableConcept
Comments

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

Contraindication.mitigation.date
Definition

Indicates when the mitigating action was documented.

Control0..1
TypedateTime
Comments

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

Contraindication.mitigation.author
Definition

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

Control0..1
TypeReference(Practitioner)