Data Type Profiles

There are no (further) constraints on this element

Element id

CodeableConcept.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

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

CodeableConcept.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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

coding

0..*

Element id

CodeableConcept.coding

Short description

A reference to a code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

While the IPS-UV specification considers this a Must Support element, some systems will not have the ability to support codings for every codeableConcept, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance.

Implementers that support codings should still send the codings for codeable concepts if they are available and receivers should not produce failures or rejections if codings are included in the patient summary in the first release (a base tenet of FHIR).

Additionally vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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 subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

text

SO Σ

0..1

Element id

CodeableConcept.text

Short description

Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

Obligations

Code	Actor
SHALL:able-to-populate	http://hl7.org/fhir/io/psca/ActorDefinition/Producer
SHALL:no-error	http://hl7.org/fhir/io/psca/ActorDefinition/Consumer

Notes:

This profile makes a significant change from the Codeable Concept (IPS) data type profile by removing the Must Support flag from the coding element.
While coding is not currently considered Must Support in Version 1.0, implementers that support codings should still send the codings for codeable concepts if they are available/appropriate and receivers should not produce failures or rejections if codings are included in the patient summary (a base tenet of FHIR).
Additionally, vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content
Implementors should also be aware that this constraint will be under consideration to be re-applied in future releases of PS-CA

CodeableConcept (Medication)

This profile applies specific constraints to the CodeableConcept data type within the context of medication code information. It is guided by the constraints used in the Codeable Concept (IPS) data type profile, with adjustments to reflect the specific needs and feedback from the community regarding medication coding. The profile mandates the presence of a textual description for each CodeableConcept instance, emphasizing the importance of clarity and understandability in medication data.

CodeableConceptMedicationPSCA (CodeableConcept)

CodeableConceptPSCA

There are no (further) constraints on this element

Element id

CodeableConcept

Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Comments

For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text.

Data type

CodeableConceptPSCA

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..1

There are no (further) constraints on this element

Element id

CodeableConcept.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

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

CodeableConcept.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

coding

SO Σ

0..*

CodingMedicationPSCA

Element id

CodeableConcept.coding

Short description

A reference to a code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.

Data type

CodingMedicationPSCA

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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 subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

Obligations

Code	Actor
SHALL:able-to-populate	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer
SHOULD:handle	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer

text

SO Σ

1..1

Element id

CodeableConcept.text

Short description

Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

Obligations

Code	Actor
SHALL:no-error	http://hl7.org/fhir/io/psca/ActorDefinition/Consumer
SHALL:no-error	http://hl7.org/fhir/io/psca/ActorDefinition/Consumer

Notes:

While the original Codeable Concept (PS-CA) profile removed the Must Support flag for the coding element, this medication-specific profile expects implementations to support and include codings for medications wherever appropriate.
In contrast to the general PS-CA CodeableConcept profile, the text element in this medication-specific profile is mandatory, ensuring that every coded concept is accompanied by a descriptive text.

Based on community feedback, the constraints and expectations of this profile may be reassessed and potentially applied to other coding elements and profiles within the PS-CA project.

Coding

The Coding (PS-CA) profile ensures systems support important Coding elements, including system, code and display. Must support expectation will be removed from version in the Coding (PS-CA) profile in 2.0.0-DFT-preBallot release in the interim with the intent to explore the topic with IPS and discuss with PSWG whether further guidance or constraints should be applied in future versions with respect to SNOMED CT country editions. It also raises awareness of the FHIR Core Translation standard extension.

This profile is informed by the constraints of the Coding with translations profile. Unlike IPS, however, the PS-CA profile does not flag the translation extension as Must Support; this may change in future releases.

CodingPSCA (Coding)

Coding

There are no (further) constraints on this element

Element id

Coding

Short description

A reference to a code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Comments

Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.

Data type

Coding

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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 subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding

0..1

There are no (further) constraints on this element

Element id

Coding.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

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

Coding.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

system

SO Σ

0..1

Element id

Coding.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

Obligations

Code	Actor
SHALL:able-to-populate	http://hl7.org/fhir/io/psca/ActorDefinition/Producer
SHALL:no-error	http://hl7.org/fhir/io/psca/ActorDefinition/Consumer

version

0..1

Element id

Coding.version

Short description

Version of the system - if relevant

Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Comments

The Must Support flag was removed from this element in response to implementer feedback. Requirements for use in certain contexts (e.g., with SNOMED CT CA edition) need to be explored by the Patient Summary Working Group before the constraint will be re-considered for inclusion

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

SO Σ

0..1

Element id

Coding.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

Obligations

Code	Actor
SHALL:able-to-populate	http://hl7.org/fhir/io/psca/ActorDefinition/Producer
SHALL:no-error	http://hl7.org/fhir/io/psca/ActorDefinition/Consumer

display

SO Σ

0..1

Element id

Coding.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

Obligations

Code	Actor
SHALL:able-to-populate	http://hl7.org/fhir/io/psca/ActorDefinition/Producer
SHALL:no-error	http://hl7.org/fhir/io/psca/ActorDefinition/Consumer

0..1

There are no (further) constraints on this element

Element id

Coding.display.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

Mappings

rim: n/a

extension

0..*

Element id

Coding.display.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

translation

0..*

Extension(Complex)

Element id

Coding.display.extension:translation

Short description

Language Translation (Localization)

Alternate names

extensions, user content

Definition

Language translation from base language of resource to another language, used to provide translations for strings, including markdown. Generally, the type of the translation extension SHOULD match that of the element being extended.

Comments

Data type

Extension(Complex)

Extension URL

Translation

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
rim: ST.translation

value

0..1

System.String

There are no (further) constraints on this element

Element id

Coding.display.value

Short description

Primitive value for string

Definition

Primitive value for string

Data type

System.String

Maximum string length

1048576

userSelected

0..1

There are no (further) constraints on this element

Element id

Coding.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

Notes:

All Must Support elements in this profile are also Must Support in IPS-UV, and there are no differences in element cardinality. Constraints are carried over into a unique PS-CA data type profile to ensure that implementers have clarity and consistency in the expectations this guide puts forth when Must Support is claimed.
Unlike IPS, the PS-CA profile does not make the Coding element, itself, Must Support. (This has been identified as a modelling issue with IPS.)
Earlier releases of this Implementation Guide included the Must Support flag on the translation extension. Based on public feedback, the Must Support flag has been removed pending a comprehensive approach to multi-language support and conformance.

Extensions

This profile uses the following extensions:

Coding.display: Translation

Coding (Medication)

The Coding Medication (PS-CA) profile introduces constraints for the Coding data type specifically designed for the medication use-case within the PS-CA project. It closely aligns with the principles of the IPS-UV Coding profile, but emphasizes the mandatory inclusion of the system and code elements.

CodingMedicationPSCA (Coding)

There are no (further) constraints on this element

Element id

Coding

Short description

A reference to a code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Comments

Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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 subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding

0..1

There are no (further) constraints on this element

Element id

Coding.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

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

Coding.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

system

SO Σ

1..1

Element id

Coding.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

Obligations

Code	Actor
SHALL:no-error	http://hl7.org/fhir/io/psca/ActorDefinition/Consumer
SHALL:no-error	http://hl7.org/fhir/io/psca/ActorDefinition/Consumer

version

0..1

There are no (further) constraints on this element

Element id

Coding.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

SO Σ

1..1

Element id

Coding.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

Obligations

Code	Actor
SHALL:no-error	http://hl7.org/fhir/io/psca/ActorDefinition/Consumer
SHALL:no-error	http://hl7.org/fhir/io/psca/ActorDefinition/Consumer

display

SO Σ

0..1

There are no (further) constraints on this element

Element id

Coding.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

Obligations

Code	Actor
SHALL:able-to-populate	http://hl7.org/fhir/io/psca/ActorDefinition/Producer
SHALL:no-error	http://hl7.org/fhir/io/psca/ActorDefinition/Consumer

0..1

There are no (further) constraints on this element

Element id

Coding.display.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

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

Coding.display.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

translation

0..*

Extension(Complex)

There are no (further) constraints on this element

Element id

Coding.display.extension:translation

Short description

Language Translation (Localization)

Alternate names

extensions, user content

Definition

Comments

Data type

Extension(Complex)

Extension URL

Translation

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
rim: ST.translation

value

0..1

System.String

There are no (further) constraints on this element

Element id

Coding.display.value

Short description

Primitive value for string

Definition

Primitive value for string

Data type

System.String

Maximum string length

1048576

userSelected

0..1

There are no (further) constraints on this element

Element id

Coding.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

Notes:

Implementers should ensure that Coding for medications always includes both the system and code elements.
While not mandatory, the inclusion of the display element is encouraged to support better understanding and communication of medication information among healthcare providers and patients.

While initially focused on medication coding, the principles and structure of this profile may inform future adaptations for other coding use-cases within the PS-CA project.

Quantity

The Data Type: Quantity (PS-CA) profile represents the constraint applied to the Quantity data type by the PS-CA project to use UCUM as the code system for units. It is informed by the constraints of the Quantity (IPS) profile.

QuantityPSCA (Quantity)

Quantity

Element id

Quantity

Short description

A measured amount using UCUM

Definition

A measured amount (or an amount that can potentially be measured). Note that measured amounts include amounts that are not precisely quantified, including amounts involving arbitrary units and floating currencies. This profile imposes that the code system for units be UCUM.

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..1

There are no (further) constraints on this element

Element id

Quantity.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

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

Quantity.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

value

0..1

There are no (further) constraints on this element

Element id

Quantity.value

Short description

Numerical value (with implicit precision)

Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: SN.2 / CQ - N/A
rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value

comparator

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

Quantity.comparator

Short description

< | <= | >= | > - how to understand the value

Definition

How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Meaning when missing

If there is no comparator, then there is no modification of the value

Data type

Binding

How the Quantity should be understood and represented.

QuantityComparator (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: SN.1 / CQ.1
rim: IVL properties

unit

0..1

There are no (further) constraints on this element

Element id

Quantity.unit

Short description

Unit representation

Definition

A human-readable form of the unit.

Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: (see OBX.6 etc.) / CQ.2
rim: PQ.unit

system

SO Σ C

1..1

uriFixed Value

Element id

Quantity.system

Short description

UCUM system for units

Definition

The identification of the system that provides the coded form of the unit.

Requirements

Need to know the system that defines the coded form of the unit.

Comments

see http://en.wikipedia.org/wiki/Uniform_resource_identifier

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, qty-3

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Fixed value

http://unitsofmeasure.org

Mappings

rim: n/a
v2: (see OBX.6 etc.) / CQ.2
rim: CO.codeSystem, PQ.translation.codeSystem

Obligations

Code	Actor
SHALL:populate	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer
SHALL:handle	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer
SHOULD:display	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer

code

SO Σ

1..1

Element id

Quantity.code

Short description

Coded form of the unit

Definition

A computer processable form of the unit in some unit representation system.

Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: (see OBX.6 etc.) / CQ.2
rim: PQ.code, MO.currency, PQ.translation.code

Obligations

Code	Actor
SHALL:populate	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer
SHALL:handle	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer
SHOULD:display	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer

Notes:

All Must Support elements in this profile are also Must Support in IPS-UV, and there are no differences in element cardinality. Constraints are carried over into a unique PS-CA data type profile to ensure that implementers have clarity and consistency in the expectations this guide puts forth when Must Support is claimed.
Unlike IPS, the PS-CA profile does not make the Quantity element, itself, Must Support. (This has been identified as a modelling issue with IPS.)

SimpleQuantity

The SimpleQuantity (PS-CA) profile represents the constraint applied to the SimpleQuantity data type by the PS-CA project to use UCUM as the code system for units in a way that is informed by the constraints of the SimpleQuantity (IPS) profile.

SimpleQuantityPS (Quantity)

SimpleQuantity

Element id

Quantity

Short description

A measured amount using UCUM

Definition

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

SimpleQuantity

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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()
sqty-1: The comparator is not used on a SimpleQuantity
comparator.empty()

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values

0..1

There are no (further) constraints on this element

Element id

Quantity.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

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

Quantity.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

value

0..1

There are no (further) constraints on this element

Element id

Quantity.value

Short description

Numerical value (with implicit precision)

Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: SN.2 / CQ - N/A
rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value

comparator

Σ ?!

0..0

codeBinding

There are no (further) constraints on this element

Element id

Quantity.comparator

Short description

< | <= | >= | > - how to understand the value

Definition

Not allowed to be used in this context

Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Meaning when missing

If there is no comparator, then there is no modification of the value

Data type

Binding

How the Quantity should be understood and represented.

QuantityComparator (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: SN.1 / CQ.1
rim: IVL properties

unit

0..1

There are no (further) constraints on this element

Element id

Quantity.unit

Short description

Unit representation

Definition

A human-readable form of the unit.

Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: (see OBX.6 etc.) / CQ.2
rim: PQ.unit

system

SO Σ C

1..1

uriFixed Value

Element id

Quantity.system

Short description

UCUM system for units

Definition

The identification of the system that provides the coded form of the unit.

Requirements

Need to know the system that defines the coded form of the unit.

Comments

see http://en.wikipedia.org/wiki/Uniform_resource_identifier

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, qty-3

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Fixed value

http://unitsofmeasure.org

Mappings

rim: n/a
v2: (see OBX.6 etc.) / CQ.2
rim: CO.codeSystem, PQ.translation.codeSystem

Obligations

Code	Actor
SHALL:populate	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer
SHALL:handle	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer
SHOULD:display	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer

code

SO Σ

1..1

Element id

Quantity.code

Short description

Coded form of the unit

Definition

A computer processable form of the unit in some unit representation system.

Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: (see OBX.6 etc.) / CQ.2
rim: PQ.code, MO.currency, PQ.translation.code

Obligations

Code	Actor
SHALL:populate	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer
SHALL:handle	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer
SHOULD:display	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer

Ratio

The Ratio (PS-CA) profile represents the constraint applied to the Ratio data type by the PS-CA project to use UCUM as the code system for units in a way that is informed by the constraints of the Ratio (IPS) profile.

RatioPSCA (Ratio)

Ratio

There are no (further) constraints on this element

Element id

Ratio

Short description

A ratio of two Quantity values - a numerator and a denominator

Definition

A relationship of two Quantity values - expressed as a numerator and a denominator.

Comments

The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to "1", Quantity should be used instead of Ratio.

Data type

Ratio

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present
(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())

Mappings

rim: n/a
v2: N/A
rim: RTO

0..1

There are no (further) constraints on this element

Element id

Ratio.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

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

Ratio.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

numerator

SO Σ C

0..1

Element id

Ratio.numerator

Short description

A measured amount using UCUM

Definition

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
rim: .numerator

Obligations

Code	Actor
SHALL:able-to-populate	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer
SHOULD:handle	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer

denominator

SO Σ C

0..1

Element id

Ratio.denominator

Short description

A measured amount using UCUM

Definition

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
rim: .denominator

Obligations

Code	Actor
SHALL:able-to-populate	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer
SHOULD:handle	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer

Notes:

All Must Support elements in this profile are also Must Support in IPS-UV, and there are no differences in element cardinality. Constraints are carried over into a unique PS-CA data type profile to ensure that implementers have clarity and consistency in the expectations this guide puts forth when Must Support is claimed.
Unlike IPS, the PS-CA profile does not make the Ratio element, itself, Must Support. (This has been identified as a modelling issue with IPS.)

Range

The Range (PS-CA) profile represents the constraint applied to the Range data type by the PS-CA project to supply SimpleQuantity values in a way that is informed by the constraints of the Range (IPS) profile.

RangePSCA (Range)

Range

There are no (further) constraints on this element

Element id

Range

Short description

Set of values bounded by low and high

Definition

A set of ordered Quantities defined by a low and high limit.

Comments

The stated low and high value are assumed to have arbitrarily high precision when it comes to determining which values are in the range. I.e. 1.99 is not in the range 2 -> 3.

Data type

Range

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
rng-2: If present, low SHALL have a lower value than high
low.empty() or high.empty() or (low <= high)

Mappings

rim: n/a
v2: NR and also possibly SN (but see also quantity)
rim: IVL<QTY[not(type="TS")]> [lowClosed="true" and highClosed="true"]or URG<QTY[not(type="TS")]>

0..1

There are no (further) constraints on this element

Element id

Range.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

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

Range.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

low

SO Σ C

0..1

Element id

Range.low

Short description

A measured amount using UCUM

Definition

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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()
sqty-1: The comparator is not used on a SimpleQuantity
comparator.empty()

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
v2: NR.1
rim: ./low

Obligations

Code	Actor
SHALL:able-to-populate	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer
SHOULD:handle	http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer

high

SO Σ C

0..1

Element id

Range.high

Short description

A measured amount using UCUM

Definition

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