ClinicalImpression -> Evolución
(la madurez de este recurso en la versión STU3 se encuentra en 0, por lo si bien es el más aducado para lo planteado es muy probable que tenga grandes cambios en futuras versiones)
Este recurso permite comunicar la evaluación clínica, donde se incluirá la descripción de los problemas y el estado del paciente y/o la explicación de los tratamientos y estrategias que mejor se adecuen para tratar la patología.
Este recurso sirve para todo tipo de evaluciones desde las más simples que pueden ser de texto hasta evoluciones que contengan un registro detallado que puede incluir evidencia de lo acontecido.
Recurso Organization ClinicalImpression
- Forma Completa
ClinicalImpression | I | ClinicalImpression | There are no (further) constraints on this element Element idClinicalImpression A clinical assessment performed when planning treatments and management strategies for a patient DefinitionA record of a clinical assessment performed to determine what problem(s) may affect the patient and before planning the treatments or management strategies that are best to manage a patient's condition. Assessments are often 1:1 with a clinical consultation / encounter, but this varies greatly depending on the clinical workflow. This resource is called "ClinicalImpression" rather than "ClinicalAssessment" to avoid confusion with the recording of assessment tools such as Apgar score. ClinicalImpression Constraints
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id | Σ | 0..1 | id | There are no (further) constraints on this element Element idClinicalImpression.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. id Constraints
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meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idClinicalImpression.meta Metadata about the resource DefinitionThe 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. Meta Constraints
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implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idClinicalImpression.implicitRules A set of rules under which this content was created DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. 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. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. uri Constraints
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language | 0..1 | codeBinding | There are no (further) constraints on this element Element idClinicalImpression.language Language of the resource content DefinitionThe base language in which the resource is written. 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). code BindingA human language. ?? (extensible)Constraints
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text | I | 0..1 | Narrative | There are no (further) constraints on this element Element idClinicalImpression.text Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA 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. 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 Constraints
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contained | 0..* | Resource | There are no (further) constraints on this element Element idClinicalImpression.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese 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. 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. Resource Mappings
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extension | I | 0..* | Extension | Element idClinicalImpression.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Extension Sliced:Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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Association-Service-ID-Extension | S I | 1..1 | Extension(http://hl7.org/fhir/StructureDefinition/Identifier) | Element idClinicalImpression.extension:Association-Service-ID-Extension Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. Extension(http://hl7.org/fhir/StructureDefinition/Identifier) Extension URL Constraints
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ReplaceAllSection-Extension | S I | 1..1 | Extension(Complex) | Element idClinicalImpression.extension:ReplaceAllSection-Extension Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. Extension(Complex) Extension URLhttp://example.org/fhir/StructureDefinition/Evolucion-ClinicalImpression-Extension-ReplaceAllSection Constraints
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modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idClinicalImpression.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay 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. 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. Extension Sliced:Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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identifier | Σ | 0..0 | Identifier | There are no (further) constraints on this element Element idClinicalImpression.identifier Business identifier DefinitionA unique identifier assigned to the clinical impression that remains consistent regardless of what server the impression is stored on. Identifier Constraints
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status | Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element idClinicalImpression.status draft | completed | entered-in-error DefinitionIdentifies the workflow status of the assessment. This element is labeled as a modifier because the status contains the code entered-in-error that marks the clinical impression as not currently valid. code BindingThe workflow state of a clinical impression. ?? (required)Constraints
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code | Σ | 0..0 | CodeableConcept | There are no (further) constraints on this element Element idClinicalImpression.code Kind of assessment performed Alternate namestype DefinitionCategorizes the type of clinical assessment performed. This is present as a place-holder only and may be removed based on feedback/work group opinion. CodeableConcept BindingIdentifies categories of clinical impressions. This is a place-holder only. It may be removed (unbound) (example)Constraints
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description | Σ | 0..0 | string | There are no (further) constraints on this element Element idClinicalImpression.description Why/how the assessment was performed DefinitionA summary of the context and/or cause of the assessment - why / where was it performed, and what patient events/status prompted it. Note that FHIR strings may not exceed 1MB in size string Constraints
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subject | Σ I | 1..1 | Reference(http://hl7.org/fhir/StructureDefinition/Patient | http://hl7.org/fhir/StructureDefinition/Group) | There are no (further) constraints on this element Element idClinicalImpression.subject Patient or group assessed DefinitionThe patient or group of individuals assessed as part of this record. Group is typically for veterinary and/or public health purposes. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(http://hl7.org/fhir/StructureDefinition/Patient | http://hl7.org/fhir/StructureDefinition/Group) Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idClinicalImpression.subject.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size string Constraints
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idClinicalImpression.subject.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Extension Sliced:Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element idClinicalImpression.subject.reference Literal reference, Relative, internal or absolute URL DefinitionA 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. 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. string Constraints
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identifier | Σ | 0..0 | Identifier | There are no (further) constraints on this element Element idClinicalImpression.subject.identifier Logical reference, when literal reference is not known DefinitionAn 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. 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. When 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Identifier Constraints
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display | Σ | 0..0 | string | There are no (further) constraints on this element Element idClinicalImpression.subject.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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. string Constraints
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context | Σ I | 0..1 | Reference(http://hl7.org/fhir/StructureDefinition/Encounter | http://hl7.org/fhir/StructureDefinition/EpisodeOfCare) | There are no (further) constraints on this element Element idClinicalImpression.context Encounter or Episode created from Alternate namesencounter DefinitionThe encounter or episode of care this impression was created as part of. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(http://hl7.org/fhir/StructureDefinition/Encounter | http://hl7.org/fhir/StructureDefinition/EpisodeOfCare) Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idClinicalImpression.context.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size string Constraints
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idClinicalImpression.context.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Extension Sliced:Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element idClinicalImpression.context.reference Literal reference, Relative, internal or absolute URL DefinitionA 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. 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. string Constraints
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identifier | Σ | 0..0 | Identifier | There are no (further) constraints on this element Element idClinicalImpression.context.identifier Logical reference, when literal reference is not known DefinitionAn 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. 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. When 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Identifier Constraints
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display | Σ | 0..0 | string | There are no (further) constraints on this element Element idClinicalImpression.context.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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. string Constraints
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effective[x] | Σ | 0..0 | There are no (further) constraints on this element Element idClinicalImpression.effective[x] Time of assessment DefinitionThe point in time or period over which the subject was assessed. This SHOULD be accurate to at least the minute, though some assessments only have a known date.
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date | Σ | 0..0 | dateTime | There are no (further) constraints on this element Element idClinicalImpression.date When the assessment was documented DefinitionIndicates when the documentation of the assessment was complete. dateTime Constraints
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assessor | Σ I | 0..1 | Reference(http://hl7.org/fhir/StructureDefinition/Practitioner) | There are no (further) constraints on this element Element idClinicalImpression.assessor The clinician performing the assessment DefinitionThe clinician performing the assessment. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(http://hl7.org/fhir/StructureDefinition/Practitioner) Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idClinicalImpression.assessor.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size string Constraints
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idClinicalImpression.assessor.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Extension Sliced:Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element idClinicalImpression.assessor.reference Literal reference, Relative, internal or absolute URL DefinitionA 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. 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. string Constraints
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identifier | Σ | 0..0 | Identifier | There are no (further) constraints on this element Element idClinicalImpression.assessor.identifier Logical reference, when literal reference is not known DefinitionAn 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. 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. When 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Identifier Constraints
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display | Σ | 0..0 | string | There are no (further) constraints on this element Element idClinicalImpression.assessor.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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. string Constraints
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previous | I | 0..0 | Reference(http://hl7.org/fhir/StructureDefinition/ClinicalImpression) | There are no (further) constraints on this element Element idClinicalImpression.previous Reference to last assessment DefinitionA reference to the last assesment that was conducted bon this patient. Assessments are often/usually ongoing in nature; a care provider (practitioner or team) will make new assessments on an ongoing basis as new data arises or the patient's conditions changes. It is always likely that multiple previous assessments exist for a patient. The point of quoting a previous assessment is that this assessment is relative to it (see resolved). Reference(http://hl7.org/fhir/StructureDefinition/ClinicalImpression) Constraints
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problem | Σ I | 0..0 | Reference(http://hl7.org/fhir/StructureDefinition/Condition | http://hl7.org/fhir/StructureDefinition/AllergyIntolerance) | There are no (further) constraints on this element Element idClinicalImpression.problem Relevant impressions of patient state DefinitionThis a list of the relevant problems/conditions for a patient. e.g. The patient is a pregnant, and cardiac congestive failure, Adenocarcinoma, and is allergic to penicillin. Reference(http://hl7.org/fhir/StructureDefinition/Condition | http://hl7.org/fhir/StructureDefinition/AllergyIntolerance) Constraints
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investigation | 0..0 | BackboneElement | There are no (further) constraints on this element Element idClinicalImpression.investigation One or more sets of investigations (signs, symptions, etc.) DefinitionOne or more sets of investigations (signs, symptions, etc.). The actual grouping of investigations vary greatly depending on the type and context of the assessment. These investigations may include data generated during the assessment process, or data previously generated and recorded that is pertinent to the outcomes. BackboneElement Constraints
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protocol | 0..0 | uri | There are no (further) constraints on this element Element idClinicalImpression.protocol Clinical Protocol followed DefinitionReference to a specific published clinical protocol that was followed during this assessment, and/or that provides evidence in support of the diagnosis. see http://en.wikipedia.org/wiki/Uniform_resource_identifier uri Constraints
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summary | 0..1 | string | There are no (further) constraints on this element Element idClinicalImpression.summary Summary of the assessment DefinitionA text summary of the investigations and the diagnosis. Note that FHIR strings may not exceed 1MB in size string Constraints
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finding | 0..0 | BackboneElement | There are no (further) constraints on this element Element idClinicalImpression.finding Possible or likely findings and diagnoses DefinitionSpecific findings or diagnoses that was considered likely or relevant to ongoing treatment. BackboneElement Constraints
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prognosisCodeableConcept | 0..0 | CodeableConcept | There are no (further) constraints on this element Element idClinicalImpression.prognosisCodeableConcept Estimate of likely outcome DefinitionEstimate of likely outcome. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. CodeableConcept BindingPrognosis or outlook findings ?? (example)Constraints
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prognosisReference | I | 0..0 | Reference(http://hl7.org/fhir/StructureDefinition/RiskAssessment) | There are no (further) constraints on this element Element idClinicalImpression.prognosisReference RiskAssessment expressing likely outcome DefinitionRiskAssessment expressing likely outcome. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(http://hl7.org/fhir/StructureDefinition/RiskAssessment) Constraints
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action | I | 0..0 | Reference(http://hl7.org/fhir/StructureDefinition/ReferralRequest | http://hl7.org/fhir/StructureDefinition/ProcedureRequest | http://hl7.org/fhir/StructureDefinition/Procedure | http://hl7.org/fhir/StructureDefinition/MedicationRequest | http://hl7.org/fhir/StructureDefinition/Appointment) | There are no (further) constraints on this element Element idClinicalImpression.action Action taken as part of assessment procedure DefinitionAction taken as part of assessment procedure. Actions recommended as a result of the impression should not be captured using the 'action' element. Reference(http://hl7.org/fhir/StructureDefinition/ReferralRequest | http://hl7.org/fhir/StructureDefinition/ProcedureRequest | http://hl7.org/fhir/StructureDefinition/Procedure | http://hl7.org/fhir/StructureDefinition/MedicationRequest | http://hl7.org/fhir/StructureDefinition/Appointment) Constraints
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note | 0..0 | Annotation | There are no (further) constraints on this element Element idClinicalImpression.note Comments made about the ClinicalImpression DefinitionCommentary about the impression, typically recorded after the impression itself was made, though supplemental notes by the original author could also appear. Don't use this element for content that should more properly appear as one of the specific elements of the impression. Annotation Constraints
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- Forma Diferencial
ClinicalImpression | I | ClinicalImpression | There are no (further) constraints on this element Element idClinicalImpression A clinical assessment performed when planning treatments and management strategies for a patient DefinitionA record of a clinical assessment performed to determine what problem(s) may affect the patient and before planning the treatments or management strategies that are best to manage a patient's condition. Assessments are often 1:1 with a clinical consultation / encounter, but this varies greatly depending on the clinical workflow. This resource is called "ClinicalImpression" rather than "ClinicalAssessment" to avoid confusion with the recording of assessment tools such as Apgar score. ClinicalImpression Constraints
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id | Σ | 0..1 | id | There are no (further) constraints on this element Element idClinicalImpression.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. id Constraints
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meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idClinicalImpression.meta Metadata about the resource DefinitionThe 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. Meta Constraints
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implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idClinicalImpression.implicitRules A set of rules under which this content was created DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. 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. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. uri Constraints
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language | 0..1 | codeBinding | There are no (further) constraints on this element Element idClinicalImpression.language Language of the resource content DefinitionThe base language in which the resource is written. 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). code BindingA human language. ?? (extensible)Constraints
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text | I | 0..1 | Narrative | There are no (further) constraints on this element Element idClinicalImpression.text Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA 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. 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 Constraints
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contained | 0..* | Resource | There are no (further) constraints on this element Element idClinicalImpression.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese 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. 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. Resource Mappings
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extension | I | 0..* | Extension | Element idClinicalImpression.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Extension Sliced:Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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Association-Service-ID-Extension | S I | 1..1 | Extension(http://hl7.org/fhir/StructureDefinition/Identifier) | Element idClinicalImpression.extension:Association-Service-ID-Extension Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. Extension(http://hl7.org/fhir/StructureDefinition/Identifier) Extension URL Constraints
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ReplaceAllSection-Extension | S I | 1..1 | Extension(Complex) | Element idClinicalImpression.extension:ReplaceAllSection-Extension Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. Extension(Complex) Extension URLhttp://example.org/fhir/StructureDefinition/Evolucion-ClinicalImpression-Extension-ReplaceAllSection Constraints
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modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idClinicalImpression.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay 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. 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. Extension Sliced:Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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identifier | Σ | 0..0 | Identifier | There are no (further) constraints on this element Element idClinicalImpression.identifier Business identifier DefinitionA unique identifier assigned to the clinical impression that remains consistent regardless of what server the impression is stored on. Identifier Constraints
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status | Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element idClinicalImpression.status draft | completed | entered-in-error DefinitionIdentifies the workflow status of the assessment. This element is labeled as a modifier because the status contains the code entered-in-error that marks the clinical impression as not currently valid. code BindingThe workflow state of a clinical impression. ?? (required)Constraints
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code | Σ | 0..0 | CodeableConcept | There are no (further) constraints on this element Element idClinicalImpression.code Kind of assessment performed Alternate namestype DefinitionCategorizes the type of clinical assessment performed. This is present as a place-holder only and may be removed based on feedback/work group opinion. CodeableConcept BindingIdentifies categories of clinical impressions. This is a place-holder only. It may be removed (unbound) (example)Constraints
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description | Σ | 0..0 | string | There are no (further) constraints on this element Element idClinicalImpression.description Why/how the assessment was performed DefinitionA summary of the context and/or cause of the assessment - why / where was it performed, and what patient events/status prompted it. Note that FHIR strings may not exceed 1MB in size string Constraints
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subject | Σ I | 1..1 | Reference(http://hl7.org/fhir/StructureDefinition/Patient | http://hl7.org/fhir/StructureDefinition/Group) | There are no (further) constraints on this element Element idClinicalImpression.subject Patient or group assessed DefinitionThe patient or group of individuals assessed as part of this record. Group is typically for veterinary and/or public health purposes. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(http://hl7.org/fhir/StructureDefinition/Patient | http://hl7.org/fhir/StructureDefinition/Group) Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idClinicalImpression.subject.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size string Constraints
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idClinicalImpression.subject.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Extension Sliced:Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element idClinicalImpression.subject.reference Literal reference, Relative, internal or absolute URL DefinitionA 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. 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. string Constraints
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identifier | Σ | 0..0 | Identifier | There are no (further) constraints on this element Element idClinicalImpression.subject.identifier Logical reference, when literal reference is not known DefinitionAn 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. 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. When 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Identifier Constraints
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display | Σ | 0..0 | string | There are no (further) constraints on this element Element idClinicalImpression.subject.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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. string Constraints
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context | Σ I | 0..1 | Reference(http://hl7.org/fhir/StructureDefinition/Encounter | http://hl7.org/fhir/StructureDefinition/EpisodeOfCare) | There are no (further) constraints on this element Element idClinicalImpression.context Encounter or Episode created from Alternate namesencounter DefinitionThe encounter or episode of care this impression was created as part of. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(http://hl7.org/fhir/StructureDefinition/Encounter | http://hl7.org/fhir/StructureDefinition/EpisodeOfCare) Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idClinicalImpression.context.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size string Constraints
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idClinicalImpression.context.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Extension Sliced:Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element idClinicalImpression.context.reference Literal reference, Relative, internal or absolute URL DefinitionA 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. 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. string Constraints
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identifier | Σ | 0..0 | Identifier | There are no (further) constraints on this element Element idClinicalImpression.context.identifier Logical reference, when literal reference is not known DefinitionAn 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. 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. When 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Identifier Constraints
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display | Σ | 0..0 | string | There are no (further) constraints on this element Element idClinicalImpression.context.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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. string Constraints
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effective[x] | Σ | 0..0 | There are no (further) constraints on this element Element idClinicalImpression.effective[x] Time of assessment DefinitionThe point in time or period over which the subject was assessed. This SHOULD be accurate to at least the minute, though some assessments only have a known date.
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date | Σ | 0..0 | dateTime | There are no (further) constraints on this element Element idClinicalImpression.date When the assessment was documented DefinitionIndicates when the documentation of the assessment was complete. dateTime Constraints
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assessor | Σ I | 0..1 | Reference(http://hl7.org/fhir/StructureDefinition/Practitioner) | There are no (further) constraints on this element Element idClinicalImpression.assessor The clinician performing the assessment DefinitionThe clinician performing the assessment. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(http://hl7.org/fhir/StructureDefinition/Practitioner) Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idClinicalImpression.assessor.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size string Constraints
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idClinicalImpression.assessor.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Extension Sliced:Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element idClinicalImpression.assessor.reference Literal reference, Relative, internal or absolute URL DefinitionA 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. 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. string Constraints
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identifier | Σ | 0..0 | Identifier | There are no (further) constraints on this element Element idClinicalImpression.assessor.identifier Logical reference, when literal reference is not known DefinitionAn 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. 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. When 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Identifier Constraints
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display | Σ | 0..0 | string | There are no (further) constraints on this element Element idClinicalImpression.assessor.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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. string Constraints
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previous | I | 0..0 | Reference(http://hl7.org/fhir/StructureDefinition/ClinicalImpression) | There are no (further) constraints on this element Element idClinicalImpression.previous Reference to last assessment DefinitionA reference to the last assesment that was conducted bon this patient. Assessments are often/usually ongoing in nature; a care provider (practitioner or team) will make new assessments on an ongoing basis as new data arises or the patient's conditions changes. It is always likely that multiple previous assessments exist for a patient. The point of quoting a previous assessment is that this assessment is relative to it (see resolved). Reference(http://hl7.org/fhir/StructureDefinition/ClinicalImpression) Constraints
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problem | Σ I | 0..0 | Reference(http://hl7.org/fhir/StructureDefinition/Condition | http://hl7.org/fhir/StructureDefinition/AllergyIntolerance) | There are no (further) constraints on this element Element idClinicalImpression.problem Relevant impressions of patient state DefinitionThis a list of the relevant problems/conditions for a patient. e.g. The patient is a pregnant, and cardiac congestive failure, Adenocarcinoma, and is allergic to penicillin. Reference(http://hl7.org/fhir/StructureDefinition/Condition | http://hl7.org/fhir/StructureDefinition/AllergyIntolerance) Constraints
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investigation | 0..0 | BackboneElement | There are no (further) constraints on this element Element idClinicalImpression.investigation One or more sets of investigations (signs, symptions, etc.) DefinitionOne or more sets of investigations (signs, symptions, etc.). The actual grouping of investigations vary greatly depending on the type and context of the assessment. These investigations may include data generated during the assessment process, or data previously generated and recorded that is pertinent to the outcomes. BackboneElement Constraints
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protocol | 0..0 | uri | There are no (further) constraints on this element Element idClinicalImpression.protocol Clinical Protocol followed DefinitionReference to a specific published clinical protocol that was followed during this assessment, and/or that provides evidence in support of the diagnosis. see http://en.wikipedia.org/wiki/Uniform_resource_identifier uri Constraints
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summary | 0..1 | string | There are no (further) constraints on this element Element idClinicalImpression.summary Summary of the assessment DefinitionA text summary of the investigations and the diagnosis. Note that FHIR strings may not exceed 1MB in size string Constraints
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finding | 0..0 | BackboneElement | There are no (further) constraints on this element Element idClinicalImpression.finding Possible or likely findings and diagnoses DefinitionSpecific findings or diagnoses that was considered likely or relevant to ongoing treatment. BackboneElement Constraints
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prognosisCodeableConcept | 0..0 | CodeableConcept | There are no (further) constraints on this element Element idClinicalImpression.prognosisCodeableConcept Estimate of likely outcome DefinitionEstimate of likely outcome. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. CodeableConcept BindingPrognosis or outlook findings ?? (example)Constraints
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prognosisReference | I | 0..0 | Reference(http://hl7.org/fhir/StructureDefinition/RiskAssessment) | There are no (further) constraints on this element Element idClinicalImpression.prognosisReference RiskAssessment expressing likely outcome DefinitionRiskAssessment expressing likely outcome. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(http://hl7.org/fhir/StructureDefinition/RiskAssessment) Constraints
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action | I | 0..0 | Reference(http://hl7.org/fhir/StructureDefinition/ReferralRequest | http://hl7.org/fhir/StructureDefinition/ProcedureRequest | http://hl7.org/fhir/StructureDefinition/Procedure | http://hl7.org/fhir/StructureDefinition/MedicationRequest | http://hl7.org/fhir/StructureDefinition/Appointment) | There are no (further) constraints on this element Element idClinicalImpression.action Action taken as part of assessment procedure DefinitionAction taken as part of assessment procedure. Actions recommended as a result of the impression should not be captured using the 'action' element. Reference(http://hl7.org/fhir/StructureDefinition/ReferralRequest | http://hl7.org/fhir/StructureDefinition/ProcedureRequest | http://hl7.org/fhir/StructureDefinition/Procedure | http://hl7.org/fhir/StructureDefinition/MedicationRequest | http://hl7.org/fhir/StructureDefinition/Appointment) Constraints
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note | 0..0 | Annotation | There are no (further) constraints on this element Element idClinicalImpression.note Comments made about the ClinicalImpression DefinitionCommentary about the impression, typically recorded after the impression itself was made, though supplemental notes by the original author could also appear. Don't use this element for content that should more properly appear as one of the specific elements of the impression. Annotation Constraints
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