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HdBe-BowelFunction

WARNING This page contains a draft CBB, as raw output from the zib export and automatic conversion to CBB. It requires thorough review and adaption to the Belgian realm. This CBB is merely added for informative use.

CBB	Description	Status
HdBe-BowelFunction	An important function of the rectum in particular is the temporary storage and excretion of feces, at the moment there is cause to do so. Disrupting the bowel functions can lead to fecal incontinence and constipation. Purpose Information on bowel function disorders is important in drawing up the nursing plan and for patient care. Furthermore, information on feces (shape and color) offers additional information on the patient’s health condition. In a transfer situation, it offers the ability to anticipate the arrival of the patient and to achieve continuity in healthcare for the patient. This way, material or expertise can be coordinated beforehand, for example. Evidence Base The definitions of the concepts were (partially) taken from the ICF definitions.	draft

CBB

Description

Status

HdBe-BowelFunction

An important function of the rectum in particular is the temporary storage and excretion of feces, at the moment there is cause to do so. Disrupting the bowel functions can lead to fecal incontinence and constipation.

Purpose

Information on bowel function disorders is important in drawing up the nursing plan and for patient care. Furthermore, information on feces (shape and color) offers additional information on the patient’s health condition. In a transfer situation, it offers the ability to anticipate the arrival of the patient and to achieve continuity in healthcare for the patient. This way, material or expertise can be coordinated beforehand, for example.

Evidence Base

The definitions of the concepts were (partially) taken from the ICF definitions.

draft

BowelFunction			BowelFunction	Element id BowelFunction Short description BowelFunction Definition Root concept of the BowelFunction information model. This root concept contains all data elements of the BowelFunction information model. Data type BowelFunction Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id BowelFunction.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id BowelFunction.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
FecalContinence		0..1	CodeableConceptBinding	Element id BowelFunction.FecalContinence Short description FecalContinence Definition Fecal continence is the voluntary control over the excretion of feces. Comments 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. Data type CodeableConcept Binding FecalContinence codes FecalContinence (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
Stoma	I	0..1	Reference(HdBe-Stoma)	Element id BowelFunction.Stoma Short description Stoma Definition Stoma describes the presence of an unnatural, surgically created opening. If the patient has a stoma, the type of stoma must be entered along with the date on and location at which the stoma and any stoma pouches were placed. An comment can also be entered. Comments 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. Data type Reference(HdBe-Stoma) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
Frequency	I	0..1	Quantity	Element id BowelFunction.Frequency Short description Frequency Definition The defecation frequency. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type Quantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
DefecationConsistency		0..1	CodeableConceptBinding	Element id BowelFunction.DefecationConsistency Short description DefecationConsistency Definition The consistency of the feces indicates the hardness of the stool. The Bristol Stool scale is used to determine this. Comments 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. Data type CodeableConcept Binding DefecationConsistency codes DefecationConsistency (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
DefecationColor		0..1	CodeableConceptBinding	Element id BowelFunction.DefecationColor Short description DefecationColor Definition The color of feces is possibly relevant for identifying underlying diseases, such as bleeding or biliary tract disease. Comments 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. Data type CodeableConcept Binding DefecationColor codes DefecationColor (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
IncontinenceMaterial	I	0..1	Reference(HdBe-MedicalDevice)	Element id BowelFunction.IncontinenceMaterial Short description IncontinenceMaterial Definition A description of the incontinence material used. Comments 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. Data type Reference(HdBe-MedicalDevice) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
Comment		0..1	string	Element id BowelFunction.Comment Short description Comment Definition A comment on the BowelFunction. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a

BowelFunction		0..*
BowelFunction.FecalContinence	CodeableConcept	0..1
BowelFunction.Stoma	Reference(HdBe-Stoma)	0..1
BowelFunction.Frequency	Quantity	0..1
BowelFunction.DefecationConsistency	CodeableConcept	0..1
BowelFunction.DefecationColor	CodeableConcept	0..1
BowelFunction.IncontinenceMaterial	Reference(HdBe-MedicalDevice)	0..1
BowelFunction.Comment	string	0..1

BowelFunction
Definition	Root concept of the BowelFunction information model. This root concept contains all data elements of the BowelFunction information model.
Cardinality	0...*
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
BowelFunction.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
BowelFunction.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	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.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
BowelFunction.FecalContinence
Definition	Fecal continence is the voluntary control over the excretion of feces.
Cardinality	0...1
Type	CodeableConcept
Binding	FecalContinence codes FecalContinence (required)
Comments	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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
BowelFunction.Stoma
Definition	Stoma describes the presence of an unnatural, surgically created opening. If the patient has a stoma, the type of stoma must be entered along with the date on and location at which the stoma and any stoma pouches were placed. An comment can also be entered.
Cardinality	0...1
Type	Reference(HdBe-Stoma)
Comments	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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
BowelFunction.Frequency
Definition	The defecation frequency.
Cardinality	0...1
Type	Quantity
Comments	The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()`
Mappings	rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
BowelFunction.DefecationConsistency
Definition	The consistency of the feces indicates the hardness of the stool. The Bristol Stool scale is used to determine this.
Cardinality	0...1
Type	CodeableConcept
Binding	DefecationConsistency codes DefecationConsistency (required)
Comments	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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
BowelFunction.DefecationColor
Definition	The color of feces is possibly relevant for identifying underlying diseases, such as bleeding or biliary tract disease.
Cardinality	0...1
Type	CodeableConcept
Binding	DefecationColor codes DefecationColor (extensible)
Comments	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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
BowelFunction.IncontinenceMaterial
Definition	A description of the incontinence material used.
Cardinality	0...1
Type	Reference(HdBe-MedicalDevice)
Comments	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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
BowelFunction.Comment
Definition	A comment on the BowelFunction.
Cardinality	0...1
Type	string
Comments	Note that FHIR strings SHALL NOT exceed 1MB in size
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a

Example instances

[CBB name]
[Concept name ]	[example value]

// example of NameInformation

## Example instances

| NameInformation      |                   |
|----------------------|-------------------|
| FirstNames | Johanna Petronella Maria   
| Initials | J.P.M. 
| GivenName | Jo 
| NameUsage | Geslachtsnaam partner gevolgd door eigen geslachtsnaam
| LastName.Prefix | van
| LastName.LastName | Putten
| LastNamePartner.PartnerPrefix | van der
| LastNamePartner.PartnerLastName | Giessen
| Titles |

zib BodyWeight-v3.2 difference

Concept	Category	Description
`[element.path]`	[category of change]	[Description of change]([Reference to ticket/issue/zulip chat using MarkDown link])

Terminology Bindings

Path	Name	Strength	URL
FecalContinence	FecalContinence	required	https://fhir.healthdata.be/ValueSet/FecalContinence
DefecationConsistency	DefecationConsistency	required	https://fhir.healthdata.be/ValueSet/DefecationConsistency
DefecationColor	DefecationColor	extensible	https://fhir.healthdata.be/ValueSet/DefecationColor