2.1. Retrieve MedMij Core - Alert (zib2017/STU3)
2.1.1. Overview
| Id | 900000404 |
| Data service name without version (English) | Retrieve MedMij Core - Alert (zib2017/STU3) |
| Data service name without version (Dutch) | Verzamelen MedMij Core - Alert (zib2017/STU3) |
| Data service version | 1.0.0-beta.1 |
| System role(s) | MMC-ALR-zib2017/STU3-1.0.0-beta.1-FHIR (PHR) MMC-ALB-zib2017/STU3-1.0.0-beta.1-FHIR (XIS) |
| Relevant domain(s) | Long-term Healthcare |
2.1.2. Functional model
| CIM | zib Alert |
| Functional version | 3.2(2017) |
The functional model can be found on ART-DECOR.
2.1.3. Technical specification
| FHIR profile(s) | http://nictiz.nl/fhir/StructureDefinition/zib-Alert |
| FHIR package | nictiz.fhir.nl.stu3.zib2017 version 2.0.0 or compatible |
| FHIR version | STU3 |
| Search request | GET [base]/Flag |
| Must Support |
|
| CapabilityStatement(s) | MedMij Core Alert Retrieve MedMij Core Alert Serve |
The FHIR profile is included below.
</telecom>
</contact>
<description value="Alert as defined by the Dutch Health and Care Information models (Dutch: Zorginformatiebouwsteen or ZIB) version 3.2, release 2017.\n\nAn alert describes a clinical or administrative fact brought to the attention of the users of the clinical systems to be taken into account when shaping diagnostic and therapeutic policy or in dealing with the patient, usually because of a safety risk. \nDisorders that describe the body’s sensitivity to a substance which results in a specific physiological reaction after being exposed to that substance are referred to as allergies. These are described in a separate information model. \nWarnings for non-allergic disorders can concern:\n- A disorder (condition or diagnosis which can be considered as a contraindication for the use of groups of medication or undergoing a certain type of therapy), such as pregnancy or long QT syndrome\n- Impaired functioning of an organ system (heart failure, impaired liver or kidney function, weakened immune system) \n- Risk of spreading certain microorganisms (multi-resistant bacteria, tubercle bacilli, HIV, HBV, Ebola virus)\n- Other risks" />
<purpose value="Documenting and entering disorders or conditions that require attention is an important part of medical registration. It concerns the core of patient safety. In the execution of research and treatment, these patient characteristics - which are marked as a warning - constantly have to be taken into account. They provide information that is important for the patient’s condition and the options a healthcare provider has for therapy. Disorders that are registered or transferred as an Alert can also be described as a Problem. The difference is in the fact that the healthcare provider considers the problem as an Alert = warning. In many cases, transfer will be subject to strict privacy rules, as the warning will not always elicit an adequate reaction in the informed environment." />
</mapping>
</mapping>
</mapping>
</mapping>
</base>
<human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
</constraint>
<human value="If the resource is contained in another resource, it SHALL NOT contain any narrative" />
</constraint>
<human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
<xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
</constraint>
<human value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource" />
<xpath value="not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))" />
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
<comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
</base>
</type>
</element>
<definition value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource." />
</base>
</type>
</element>
<definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content." />
<comment value="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. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation." />
</base>
</type>
</element>
<comment value="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)." />
</base>
</type>
</extension>
</extension>
</extension>
</valueSetReference>
</binding>
</element>
<definition value="A human-readable narrative that contains a summary of the resource, and may 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 value="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 in formation is added later." />
</base>
</type>
</mapping>
</element>
<definition value="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 value="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." />
</base>
</type>
</mapping>
</element>
</slicing>
<definition value="May be used to represent additional information that is not part of the basic definition of the resource. In order 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." />
<comment value="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." />
</base>
</type>
</mapping>
</element>
<definition value="The patient’s health problem or condition that is the subject of the alert. This could involve a patient’s episode of care, problem, condition or diagnosis that is seen as a contraindication in prescribing medication or which has to be taken into account when shaping diagnostic and therapeutic policy. This can be in the patient’s own interest, or it can involve a problem or disorder that can make the patient a risk to their surroundings, such as an infection hazard. These are references to conditions included on the patient’s problem list.\nIf there is a contraindication, the code system G-Standard Contraindications (Table 40) from the ProblemNameCodeList of the ConcernTransfer information model should be used." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</type>
</mapping>
</element>
</discriminator>
</slicing>
<definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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." />
<comment value="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." />
</base>
</type>
</mapping>
</element>
<comment value="The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension." />
</base>
</type>
</mapping>
</element>
<definition value="Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list)." />
<comment value="Within the context of zib-Alert the concern reference is only supposed to refer to zib-Problem. The reference is unconstrained to allow other use cases." />
</base>
</type>
</mapping>
</element>
<definition value="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. Usually modifier elements provide negation or qualification. In order 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." />
<comment value="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." />
</base>
</type>
</mapping>
</element>
<definition value="Identifier assigned to the flag for external use (outside the FHIR environment)." />
</base>
</type>
</mapping>
</mapping>
</mapping>
</element>
<comment value="This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid." />
</base>
</type>
</extension>
<description value="Indicates whether this flag is active and needs to be displayed to a user, or whether it is no longer needed or entered in error." />
</valueSetReference>
</binding>
</mapping>
</mapping>
</element>
<definition value="Indicates the type of alert, meaning a rough description of the cause or origin of the warning." />
</base>
</type>
</coding>
</valueCodeableConcept>
</example>
</extension>
<description value="Indicates the type of alert, meaning a rough description of the cause or origin of the warning." />
<reference value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.3.1--20171231000000" />
</valueSetReference>
</binding>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="A warning, other than a condition or problem. For example, a patient can be given an ‘Aggressive patient' alert.\nThe warning can be entered in code (there are codes for frequently used alerts), but seeing the dynamic nature of the warnings cf. SARS and Ebola, these alerts will often be entered as free text." />
<comment value="According to HCIM Alert this element does not need to be filled if a reference to HCIM Problem exists. In that case, instead of leaving this element empty, the NullFlavor with `.coding.code` equal to 'OTH' SHOULD be used." />
</base>
</type>
</coding>
</valueCodeableConcept>
</example>
</extension>
<reference value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.3.2--20171231000000" />
</valueSetReference>
</binding>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="The patient, location, group , organization , or practitioner, etc. this is about record this flag is associated with." />
</base>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</mapping>
</mapping>
</element>
<definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</type>
</mapping>
</element>
</discriminator>
</slicing>
<definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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." />
<comment value="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." />
</base>
</type>
</mapping>
</element>
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</mapping>
</element>
<definition value="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 value="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." />
</base>
</type>
</mapping>
</element>
<definition value="An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity 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 value="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. \n\nWhen 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\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it." />
</base>
</type>
</mapping>
</element>
</extension>
<definition value="Plain text narrative that identifies the resource in addition to the resource reference." />
<comment value="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." />
</base>
</type>
</mapping>
</element>
<definition value="The period of time from the activation of the flag to inactivation of the flag. If the flag is active, the end of the period should be unspecified." />
</base>
</type>
</mapping>
</element>
<definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</type>
</mapping>
</element>
</discriminator>
</slicing>
<definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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." />
<comment value="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." />
</base>
</type>
</mapping>
</element>
<definition value="The date and time at which the described condition was entered as a warning.\nThis can be an exact date and time, or a rough indication of the date (such as only the year, or the month and the year)." />
<comment value="If the low element is missing, the meaning is that the low boundary is not known." />
</base>
</type>
</example>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time." />
<comment value="The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03." />
</base>
</type>
<meaningWhenMissing value="If the end of the period is missing, it means that the period is ongoing" />
</mapping>
</mapping>
</element>
<comment value="If both Flag.encounter and Flag.period are valued, then Flag.period.start shall not be before Encounter.period.start and Flag.period.end shall not be after Encounter.period.end." />
</base>
</type>
</mapping>
</element>
</base>
</type>
</type>
</type>
</type>
</mapping>
</mapping>
</mapping>
</element>
<definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</type>
</mapping>
</element>
</discriminator>
</slicing>
<definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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." />
<comment value="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." />
</base>
</type>
</mapping>
</element>
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</mapping>
</element>
<definition value="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 value="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." />
</base>
</type>
</mapping>
</element>
<definition value="An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity 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 value="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. \n\nWhen 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\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it." />
</base>
</type>
</mapping>
</element>
</extension>
<definition value="Plain text narrative that identifies the resource in addition to the resource reference." />
<comment value="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." />
</base>
</type>
</mapping>
</element>
</snapshot>
</mapping>
</mapping>
</mapping>
</element>
</slicing>
</element>
<definition value="The patient’s health problem or condition that is the subject of the alert. This could involve a patient’s episode of care, problem, condition or diagnosis that is seen as a contraindication in prescribing medication or which has to be taken into account when shaping diagnostic and therapeutic policy. This can be in the patient’s own interest, or it can involve a problem or disorder that can make the patient a risk to their surroundings, such as an infection hazard. These are references to conditions included on the patient’s problem list.\nIf there is a contraindication, the code system G-Standard Contraindications (Table 40) from the ProblemNameCodeList of the ConcernTransfer information model should be used." />
</type>
</mapping>
</mapping>
</mapping>
</element>
<comment value="Within the context of zib-Alert the concern reference is only supposed to refer to zib-Problem. The reference is unconstrained to allow other use cases." />
</element>
</mapping>
</element>
<definition value="Indicates the type of alert, meaning a rough description of the cause or origin of the warning." />
</coding>
</valueCodeableConcept>
</example>
<description value="Indicates the type of alert, meaning a rough description of the cause or origin of the warning." />
<reference value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.3.1--20171231000000" />
</valueSetReference>
</binding>
</mapping>
</mapping>
</mapping>
</element>
<definition value="A warning, other than a condition or problem. For example, a patient can be given an ‘Aggressive patient' alert.\nThe warning can be entered in code (there are codes for frequently used alerts), but seeing the dynamic nature of the warnings cf. SARS and Ebola, these alerts will often be entered as free text." />
<comment value="According to HCIM Alert this element does not need to be filled if a reference to HCIM Problem exists. In that case, instead of leaving this element empty, the NullFlavor with `.coding.code` equal to 'OTH' SHOULD be used." />
</coding>
</valueCodeableConcept>
</example>
<reference value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.3.2--20171231000000" />
</valueSetReference>
</binding>
</mapping>
</mapping>
</mapping>
</element>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</element>
</slicing>
</element>
</type>
</element>
<definition value="The date and time at which the described condition was entered as a warning.\nThis can be an exact date and time, or a rough indication of the date (such as only the year, or the month and the year)." />
</example>
</mapping>
</mapping>
</mapping>
</element>
</type>
</element>
</type>
</type>
</type>
</type>
</mapping>
</element>
</slicing>
</element>
</type>
</element>
</differential>
</StructureDefinition>
{
{
]
}
],
"description": "Alert as defined by the Dutch Health and Care Information models (Dutch: Zorginformatiebouwsteen or ZIB) version 3.2, release 2017.\n\nAn alert describes a clinical or administrative fact brought to the attention of the users of the clinical systems to be taken into account when shaping diagnostic and therapeutic policy or in dealing with the patient, usually because of a safety risk. \nDisorders that describe the body’s sensitivity to a substance which results in a specific physiological reaction after being exposed to that substance are referred to as allergies. These are described in a separate information model. \nWarnings for non-allergic disorders can concern:\n- A disorder (condition or diagnosis which can be considered as a contraindication for the use of groups of medication or undergoing a certain type of therapy), such as pregnancy or long QT syndrome\n- Impaired functioning of an organ system (heart failure, impaired liver or kidney function, weakened immune system) \n- Risk of spreading certain microorganisms (multi-resistant bacteria, tubercle bacilli, HIV, HBV, Ebola virus)\n- Other risks",
"purpose": "Documenting and entering disorders or conditions that require attention is an important part of medical registration. It concerns the core of patient safety. In the execution of research and treatment, these patient characteristics - which are marked as a warning - constantly have to be taken into account. They provide information that is important for the patient’s condition and the options a healthcare provider has for therapy. Disorders that are registered or transferred as an Alert can also be described as a Problem. The difference is in the fact that the healthcare provider considers the problem as an Alert = warning. In many cases, transfer will be subject to strict privacy rules, as the warning will not always elicit an adequate reaction in the informed environment.",
{
},
{
},
{
},
{
}
],
{
"Barriers to Care",
"Alert",
"Warning"
],
},
{
},
{
},
{
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
},
{
"human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource",
"xpath": "not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))",
}
],
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
},
],
},
{
"definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.",
},
],
},
{
"definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
"comment": "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. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
},
],
},
{
"comment": "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).",
},
],
{
}
},
{
},
{
}
],
}
}
},
{
"definition": "A human-readable narrative that contains a summary of the resource, and may 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": "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 in formation is added later.",
"narrative",
"html",
"xhtml",
"display"
],
},
],
"dom-1"
],
]
},
{
"definition": "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": "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.",
"inline resources",
"anonymous resources",
"contained resources"
],
},
],
]
},
{
},
"definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order 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.",
"comment": "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.",
"extensions",
"user content"
],
},
],
]
},
{
"definition": "The patient’s health problem or condition that is the subject of the alert. This could involve a patient’s episode of care, problem, condition or diagnosis that is seen as a contraindication in prescribing medication or which has to be taken into account when shaping diagnostic and therapeutic policy. This can be in the patient’s own interest, or it can involve a problem or disorder that can make the patient a risk to their surroundings, such as an infection hazard. These are references to conditions included on the patient’s problem list.\nIf there is a contraindication, the code system G-Standard Contraindications (Table 40) from the ProblemNameCodeList of the ConcernTransfer information model should be used.",
"comment": "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.",
"extensions",
"user content",
"Conditie"
],
},
],
"ele-1"
],
{
},
{
}
],
{
},
{
},
{
},
{
}
]
},
{
"xmlAttr"
],
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
],
]
},
{
],
},
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
"comment": "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.",
"extensions",
"user content"
],
},
],
]
},
{
"xmlAttr"
],
"comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
},
],
]
},
{
"definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
"comment": "Within the context of zib-Alert the concern reference is only supposed to refer to zib-Problem. The reference is unconstrained to allow other use cases.",
},
],
]
},
{
"definition": "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. Usually modifier elements provide negation or qualification. In order 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.",
"comment": "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.",
"extensions",
"user content"
],
},
],
]
},
{
},
],
{
},
{
},
{
}
]
},
{
"comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
},
],
{
}
],
"description": "Indicates whether this flag is active and needs to be displayed to a user, or whether it is no longer needed or entered in error.",
}
},
]
},
{
"definition": "Indicates the type of alert, meaning a rough description of the cause or origin of the warning.",
"AlertType"
],
},
],
{
]
}
}
],
{
}
],
"description": "Indicates the type of alert, meaning a rough description of the cause or origin of the warning.",
"reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.3.1--20171231000000",
}
},
{
},
{
},
{
},
{
},
{
}
]
},
{
"definition": "A warning, other than a condition or problem. For example, a patient can be given an ‘Aggressive patient' alert.\nThe warning can be entered in code (there are codes for frequently used alerts), but seeing the dynamic nature of the warnings cf. SARS and Ebola, these alerts will often be entered as free text.",
"comment": "According to HCIM Alert this element does not need to be filled if a reference to HCIM Problem exists. In that case, instead of leaving this element empty, the NullFlavor with `.coding.code` equal to 'OTH' SHOULD be used.",
"AlertNaam"
],
},
],
{
{
}
]
}
}
],
{
}
],
"reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.3.2--20171231000000",
}
},
{
},
{
},
{
},
{
},
{
}
]
},
{
"definition": "The patient, location, group , organization , or practitioner, etc. this is about record this flag is associated with.",
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
}
],
{
},
{
}
]
},
{
"xmlAttr"
],
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
],
]
},
{
],
},
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
"comment": "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.",
"extensions",
"user content"
],
},
],
]
},
{
"comment": "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.",
"extensions",
"user content"
],
},
{
}
],
"ele-1"
],
{
},
{
}
],
]
},
{
"definition": "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": "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.",
},
],
"ref-1"
],
]
},
{
"definition": "An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity 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": "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. \n\nWhen 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\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.",
},
],
]
},
{
{
}
],
"definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
"comment": "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.",
},
],
]
},
{
"definition": "The period of time from the activation of the flag to inactivation of the flag. If the flag is active, the end of the period should be unspecified.",
},
],
]
},
{
"xmlAttr"
],
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
],
]
},
{
],
},
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
"comment": "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.",
"extensions",
"user content"
],
},
],
]
},
{
"definition": "The date and time at which the described condition was entered as a warning.\nThis can be an exact date and time, or a rough indication of the date (such as only the year, or the month and the year).",
"BeginDatumTijd"
],
},
],
],
"per-1"
],
{
},
{
},
{
},
{
},
{
}
]
},
{
"definition": "The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.",
"comment": "The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.",
},
],
"per-1"
],
]
},
{
"comment": "If both Flag.encounter and Flag.period are valued, then Flag.period.start shall not be before Encounter.period.start and Flag.period.end shall not be after Encounter.period.end.",
},
],
]
},
{
},
{
},
{
},
{
},
{
}
],
{
},
{
},
{
}
]
},
{
"xmlAttr"
],
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
],
]
},
{
],
},
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
"comment": "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.",
"extensions",
"user content"
],
},
],
]
},
{
"comment": "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.",
"extensions",
"user content"
],
},
{
}
],
"ele-1"
],
{
},
{
}
],
]
},
{
"definition": "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": "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.",
},
],
"ref-1"
],
]
},
{
"definition": "An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity 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": "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. \n\nWhen 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\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.",
},
],
]
},
{
{
}
],
"definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
"comment": "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.",
},
],
]
}
]
},
{
{
},
{
},
{
}
]
},
{
}
},
{
"definition": "The patient’s health problem or condition that is the subject of the alert. This could involve a patient’s episode of care, problem, condition or diagnosis that is seen as a contraindication in prescribing medication or which has to be taken into account when shaping diagnostic and therapeutic policy. This can be in the patient’s own interest, or it can involve a problem or disorder that can make the patient a risk to their surroundings, such as an infection hazard. These are references to conditions included on the patient’s problem list.\nIf there is a contraindication, the code system G-Standard Contraindications (Table 40) from the ProblemNameCodeList of the ConcernTransfer information model should be used.",
"Conditie"
],
],
{
},
{
},
{
}
]
},
{
"comment": "Within the context of zib-Alert the concern reference is only supposed to refer to zib-Problem. The reference is unconstrained to allow other use cases."
},
{
{
}
]
},
{
"definition": "Indicates the type of alert, meaning a rough description of the cause or origin of the warning.",
"AlertType"
],
{
]
}
}
],
"description": "Indicates the type of alert, meaning a rough description of the cause or origin of the warning.",
"reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.3.1--20171231000000",
}
},
{
},
{
},
{
}
]
},
{
"definition": "A warning, other than a condition or problem. For example, a patient can be given an ‘Aggressive patient' alert.\nThe warning can be entered in code (there are codes for frequently used alerts), but seeing the dynamic nature of the warnings cf. SARS and Ebola, these alerts will often be entered as free text.",
"comment": "According to HCIM Alert this element does not need to be filled if a reference to HCIM Problem exists. In that case, instead of leaving this element empty, the NullFlavor with `.coding.code` equal to 'OTH' SHOULD be used.",
"AlertNaam"
],
{
{
}
]
}
}
],
"reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.3.2--20171231000000",
}
},
{
},
{
},
{
}
]
},
{
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
}
},
{
{
}
]
},
{
"definition": "The date and time at which the described condition was entered as a warning.\nThis can be an exact date and time, or a rough indication of the date (such as only the year, or the month and the year).",
"BeginDatumTijd"
],
],
{
},
{
},
{
}
]
},
{
]
},
{
{
},
{
},
{
},
{
}
],
]
},
{
}
},
{
{
}
]
}
]
}
}