Page Status: updated 2025-02-18

DetectedIssue

Page index

Introduction
Overview
- Contained resources
Details
Supported operations
- HTTP methods
- Query operations

Introduction

The DetectedIssue resource, shown in the profile NLLDetectedIssue, is a contained resource that can exist within a MedicationRequest, MedicationDispense or OperationOutcome. A DetectedIssue holds information about issues found by the Automatic Format and Constitution Control (AFF).

AFF controls consist of a number of different validations, each of which checks the contents of a prescription or dispense in a dispatch. The purpose of the AFF controls is to ensure the quality of the prescriptions saved in the National Medicines List, and to ensure, as far as possible, that statutory requirements for dispatches are met. An AFF control is included in one or more control sets and each AFF control has a unique error code and an error message.

Regarding information about how the "must support"-property is used in the Swedish National MedicationList, please refer to the page Resources

Overview

NLLDetectedIssue (DetectedIssue)	I		DetectedIssue	Element id DetectedIssue Short description Issue according to Automatic Format and Constitution Control (AFF) Alternate names DDI, drug-drug interaction, Contraindication, Alert Definition Indicates a issue with a MedcationRequest or a MedicationDispense according to the Automatic Format and Constitution Control (AFF) . Data type DetectedIssue Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() Mappings rim: Entity. Role, or Act workflow: Event v2: Partial mapping from messages containing the AL1 or IAM segment, such as the ADT^A01, ADT^A08, and ADT^A60. rim: Observation[classCode=ALRT, moodCode=EVN)
id	Σ	0..1	string	There are no (further) constraints on this element Element id DetectedIssue.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id DetectedIssue.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id DetectedIssue.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments 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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id DetectedIssue.language Short description Language of the resource content Definition The base language in which the resource is written. Comments 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). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text		0..1	Narrative	There are no (further) constraints on this element Element id DetectedIssue.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can 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. Comments 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 information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id DetectedIssue.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments 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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: N/A
extension	I	0..*	Extension	Element id DetectedIssue.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 resource. 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) 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
nllDispatchRowNo	S I	0..1	Extension(decimal)	Element id DetectedIssue.extension:nllDispatchRowNo Short description Identifier for MedicationDispense within dispatch Alternate names extensions, user content Definition Used when communicationg an error or warning for a MedicationDispense within a dispatch. The DispatchRowNo (sv Aktörens expeditionsradnummer) uniquely identifies a MediationDispense within a dispatch. 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(decimal) Extension URL http://electronichealth.se/fhir/StructureDefinition/NLLDispatchRowNo 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 EHM: Aktörens expeditionsradnummer
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id DetectedIssue.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. 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 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
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element id DetectedIssue.identifier Short description Unique id for the detected issue Definition Business identifier associated with the detected issue record. Requirements Allows linking instances of the same detected issue found on different servers. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.identifier w5: FiveWs.identifier v2: IAM-7 rim: .id
status	S Σ ?!	1..1	codeBinding	Element id DetectedIssue.status Short description preliminary Alternate names status Definition Indicates the status of the detected issue. The status "preliminary" is used for in the Swedish National Medication List as the detected issues always are generated from the current conditions. Comments This element is labeled as a modifier because the status contains the codes cancelled and entered-in-error that mark the issue as not currently valid. Data type code Binding Indicates the status of the identified issue. detected-issue-status (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.status w5: FiveWs.status EHM: Status på avvikelse
code	S Σ	1..1	CodeableConceptBinding	Element id DetectedIssue.code Short description AFF error or warning Alternate names type Definition Code identifying the Automatic Format and Constitution Control (AFF) error or warning. Data type CodeableConcept Binding Codes identifying the Automatic Format and Constitution Control (AFF) error or warning aff-codes (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.code w5: FiveWs.class v2: AL1-2 / IAM-9 rim: .code EHM: AFF-resultat
id		0..1	string	There are no (further) constraints on this element Element id DetectedIssue.code.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 DetectedIssue.code.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
coding	S Σ	1..1	Coding	There are no (further) constraints on this element Element id DetectedIssue.code.coding Short description 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. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id DetectedIssue.code.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 string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id DetectedIssue.code.coding.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
system	S Σ	0..1	uri	There are no (further) constraints on this element Element id DetectedIssue.code.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 uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	S Σ	0..1	string	There are no (further) constraints on this element Element id DetectedIssue.code.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 Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	S Σ	1..1	code	Element id DetectedIssue.code.coding.code Short description Issue code Definition A code identifying the reason of the issue Requirements Need to refer to a particular code in the system. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code EHM: AFF-felkod
display	S Σ	0..1	string	Element id DetectedIssue.code.coding.display Short description Error description Definition A short text describing the meaning of the error code Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName EHM: AFF-felmeddelande
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id DetectedIssue.code.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 boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings 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 ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id DetectedIssue.code.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 string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
severity	S Σ	0..1	codeBinding	Element id DetectedIssue.severity Short description moderate \| low Alternate names severity Definition In the Swedish National Medication List there are two severety levels: "Low" which corresponds to "Accepted with a warning" (Accepterad med varning) or "Moderate" which corresponds to "Rejected" (Avvisad) Data type code Binding Indicates the potential degree of impact of the identified issue on the patient. detected-issue-severity (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.grade v2: AL1-4/ IAR-2 rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV].value EHM: Allvarlighetsgrad
patient	Σ	0..1	Reference(Patient)	There are no (further) constraints on this element Element id DetectedIssue.patient Short description Associated patient Definition Indicates the patient whose record the detected issue is associated with. Requirements While the subject could be inferred by tracing the subject of the implicated resources, it's useful to have a direct link for query purposes. Data type Reference(Patient) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.subject w5: FiveWs.subject[x] v2: PID-3 rim: .participation[typeCode=SBJ].role[classCode=PAT] w5: FiveWs.subject
identified[x]	S Σ	0..1		Element id DetectedIssue.identified[x] Short description Date and time when identified Definition The date and time when the Automatic Format and Constitution Control (Automatisk format- och författningskontroll, AFF) was made. Requirements No-one can be responsible for mitigation prior to the issue being identified. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.occurrence[x] w5: FiveWs.recorded v2: ALI-6 / IAM-11 rim: .effectiveTime EHM: Kontrolltidpunkt
identifiedDateTime			dateTime	Data type dateTime
author	Σ	0..1	Reference(Practitioner \| PractitionerRole \| Device)	There are no (further) constraints on this element Element id DetectedIssue.author Short description The provider or device that identified the issue Definition Individual or device responsible for the issue being raised. For example, a decision support application or a pharmacist conducting a medication review. Data type Reference(Practitioner \| PractitionerRole \| Device) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.performer.actor w5: FiveWs.author v2: IAM-14 / IAM-16 rim: .participation[typeCode=AUT].role[classCode=ASSIGNED]
implicated	Σ	0..*	Reference(Resource)	There are no (further) constraints on this element Element id DetectedIssue.implicated Short description Problem resource Alternate names cause Definition Indicates the resource representing the current activity or proposed activity that is potentially problematic. Comments There's an implicit constraint on the number of implicated resources based on DetectedIssue.type; e.g. For drug-drug, there would be more than one. For timing, there would typically only be one. Data type Reference(Resource) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.reasonReference rim: .outboundRelationship[typeCode=SUBJ].target[moodCode=EVN, INT]
evidence		0..*	BackboneElement	There are no (further) constraints on this element Element id DetectedIssue.evidence Short description Supporting evidence Definition Supporting evidence or manifestations that provide the basis for identifying the detected issue such as a GuidanceResponse or MeasureReport. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.why[x]
id		0..1	string	There are no (further) constraints on this element Element id DetectedIssue.evidence.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 DetectedIssue.evidence.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 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
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id DetectedIssue.evidence.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. 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 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
code		0..*	CodeableConcept	There are no (further) constraints on this element Element id DetectedIssue.evidence.code Short description Manifestation Definition A manifestation that led to the recording of this detected issue. Data type CodeableConcept Binding Codes that describes the types of evidence for a detected issue. ManifestationAndSymptomCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.why[x]
detail		0..*	Reference(Resource)	There are no (further) constraints on this element Element id DetectedIssue.evidence.detail Short description Supporting information Definition Links to resources that constitute evidence for the detected issue such as a GuidanceResponse or MeasureReport. Data type Reference(Resource) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.why[x]
detail		0..1	string	There are no (further) constraints on this element Element id DetectedIssue.detail Short description Description and context Definition A textual explanation of the detected issue. Comments Should focus on information not covered elsewhere as discrete data - no need to duplicate the narrative. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.note v2: AL1-5 / IAM-8 rim: .text
reference		0..1	uri	There are no (further) constraints on this element Element id DetectedIssue.reference Short description Authority for issue Definition The literature, knowledge-base or similar reference that describes the propensity for the detected issue identified. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=INST].target[classCode=ALRT, moodCode=DEFN].text.uri
mitigation		0..*	BackboneElement	There are no (further) constraints on this element Element id DetectedIssue.mitigation Short description Step taken to address Definition Indicates an action that has been taken or is committed to reduce or eliminate the likelihood of the risk identified by the detected issue from manifesting. Can also reflect an observation of known mitigating factors that may reduce/eliminate the need for any action. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=MITG].target[classCode=ACT, moodCode=EVN]
id		0..1	string	There are no (further) constraints on this element Element id DetectedIssue.mitigation.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 DetectedIssue.mitigation.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 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
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id DetectedIssue.mitigation.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. 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 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
action		1..1	CodeableConceptBinding	There are no (further) constraints on this element Element id DetectedIssue.mitigation.action Short description What mitigation? Definition Describes the action that was taken or the observation that was made that reduces/eliminates the risk associated with the identified issue. Comments The "text" component can be used for detail or when no appropriate code exists. Data type CodeableConcept Binding Codes describing steps taken to resolve the issue or other circumstances that mitigate the risk associated with the issue; e.g. 'added concurrent therapy', 'prior therapy documented', etc. DetectedIssueMitigationAction (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .code
date		0..1	dateTime	There are no (further) constraints on this element Element id DetectedIssue.mitigation.date Short description Date committed Definition Indicates when the mitigating action was documented. Comments This might not be the same as when the mitigating step was actually taken. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .effectiveTime
author		0..1	Reference(Practitioner \| PractitionerRole)	There are no (further) constraints on this element Element id DetectedIssue.mitigation.author Short description Who is committing? Definition Identifies the practitioner who determined the mitigation and takes responsibility for the mitigation step occurring. Data type Reference(Practitioner \| PractitionerRole) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .participation[typeCode=AUT].role[classCode=ASSIGNED]

DetectedIssue
Definition	Indicates a issue with a MedcationRequest or a MedicationDispense according to the Automatic Format and Constitution Control (AFF) .
Cardinality	0...*
Alias	DDI, drug-drug interaction, Contraindication, Alert
Invariants	dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists()
Mappings	rim: Entity. Role, or Act workflow: Event v2: Partial mapping from messages containing the AL1 or IAM segment, such as the ADT^A01, ADT^A08, and ADT^A60. rim: Observation[classCode=ALRT, moodCode=EVN)
DetectedIssue.id
Definition	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality	0...1
Type	string
Summary	True
Comments	The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
DetectedIssue.meta
Definition	The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Cardinality	0...1
Type	Meta
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
DetectedIssue.implicitRules
Definition	A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Cardinality	0...1
Type	uri
Modifier	True
Summary	True
Comments	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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
DetectedIssue.language
Definition	The base language in which the resource is written.
Cardinality	0...1
Type	code
Binding	A human language. CommonLanguages (preferred)
Comments	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).
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
DetectedIssue.text
Definition	A human-readable narrative that contains a summary of the resource and can 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.
Cardinality	0...1
Type	Narrative
Alias	narrative, html, xhtml, display
Comments	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 information is added later.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: Act.text?
DetectedIssue.contained
Definition	These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Cardinality	0...*
Type	Resource
Alias	inline resources, anonymous resources, contained resources
Comments	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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Mappings	rim: N/A
DetectedIssue.extension
Definition	May be used to represent additional information that is not part of the basic definition of the resource. 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
DetectedIssue.extension:nllDispatchRowNo
Definition	Used when communicationg an error or warning for a MedicationDispense within a dispatch. The DispatchRowNo (sv Aktörens expeditionsradnummer) uniquely identifies a MediationDispense within a dispatch.
Cardinality	0...1
Type	Extension(decimal)
Must Support	True
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.
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 EHM: Aktörens expeditionsradnummer
DetectedIssue.modifierExtension
Definition	May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality	0...*
Type	Extension
Modifier	True
Alias	extensions, user content
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
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.
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
DetectedIssue.identifier
Definition	Business identifier associated with the detected issue record.
Cardinality	0...*
Type	Identifier
Summary	True
Requirements	Allows linking instances of the same detected issue found on different servers.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.identifier w5: FiveWs.identifier v2: IAM-7 rim: .id
DetectedIssue.status
Definition	Indicates the status of the detected issue. The status "preliminary" is used for in the Swedish National Medication List as the detected issues always are generated from the current conditions.
Cardinality	1...1
Type	code
Binding	Indicates the status of the identified issue. detected-issue-status (required)
Must Support	True
Modifier	True
Summary	True
Alias	status
Comments	This element is labeled as a modifier because the status contains the codes cancelled and entered-in-error that mark the issue as not currently valid.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.status w5: FiveWs.status EHM: Status på avvikelse
DetectedIssue.code
Definition	Code identifying the Automatic Format and Constitution Control (AFF) error or warning.
Cardinality	1...1
Type	CodeableConcept
Binding	Codes identifying the Automatic Format and Constitution Control (AFF) error or warning aff-codes (required)
Must Support	True
Summary	True
Alias	type
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.code w5: FiveWs.class v2: AL1-2 / IAM-9 rim: .code EHM: AFF-resultat
DetectedIssue.code.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
DetectedIssue.code.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
DetectedIssue.code.coding
Definition	A reference to a code defined by a terminology system.
Cardinality	1...1
Type	Coding
Must Support	True
Summary	True
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. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
DetectedIssue.code.coding.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
DetectedIssue.code.coding.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
DetectedIssue.code.coding.system
Definition	The identification of the code system that defines the meaning of the symbol in the code.
Cardinality	0...1
Type	uri
Must Support	True
Summary	True
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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
DetectedIssue.code.coding.version
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.
Cardinality	0...1
Type	string
Must Support	True
Summary	True
Comments	Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
DetectedIssue.code.coding.code
Definition	A code identifying the reason of the issue
Cardinality	1...1
Type	code
Must Support	True
Summary	True
Requirements	Need to refer to a particular code in the system.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code EHM: AFF-felkod
DetectedIssue.code.coding.display
Definition	A short text describing the meaning of the error code
Cardinality	0...1
Type	string
Must Support	True
Summary	True
Requirements	Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName EHM: AFF-felmeddelande
DetectedIssue.code.coding.userSelected
Definition	Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality	0...1
Type	boolean
Summary	True
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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	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 ]
DetectedIssue.code.text
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.
Cardinality	0...1
Type	string
Summary	True
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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
DetectedIssue.severity
Definition	In the Swedish National Medication List there are two severety levels: "Low" which corresponds to "Accepted with a warning" (Accepterad med varning) or "Moderate" which corresponds to "Rejected" (Avvisad)
Cardinality	0...1
Type	code
Binding	Indicates the potential degree of impact of the identified issue on the patient. detected-issue-severity (required)
Must Support	True
Summary	True
Alias	severity
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.grade v2: AL1-4/ IAR-2 rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV].value EHM: Allvarlighetsgrad
DetectedIssue.patient
Definition	Indicates the patient whose record the detected issue is associated with.
Cardinality	0...1
Type	Reference(Patient)
Summary	True
Requirements	While the subject could be inferred by tracing the subject of the implicated resources, it's useful to have a direct link for query purposes.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.subject w5: FiveWs.subject[x] v2: PID-3 rim: .participation[typeCode=SBJ].role[classCode=PAT] w5: FiveWs.subject
DetectedIssue.identified[x]
Definition	The date and time when the Automatic Format and Constitution Control (Automatisk format- och författningskontroll, AFF) was made.
Cardinality	0...1
Type	dateTime
Must Support	True
Summary	True
Requirements	No-one can be responsible for mitigation prior to the issue being identified.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.occurrence[x] w5: FiveWs.recorded v2: ALI-6 / IAM-11 rim: .effectiveTime EHM: Kontrolltidpunkt
DetectedIssue.author
Definition	Individual or device responsible for the issue being raised. For example, a decision support application or a pharmacist conducting a medication review.
Cardinality	0...1
Type	Reference(Practitioner \| PractitionerRole \| Device)
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.performer.actor w5: FiveWs.author v2: IAM-14 / IAM-16 rim: .participation[typeCode=AUT].role[classCode=ASSIGNED]
DetectedIssue.implicated
Definition	Indicates the resource representing the current activity or proposed activity that is potentially problematic.
Cardinality	0...*
Type	Reference(Resource)
Summary	True
Alias	cause
Comments	There's an implicit constraint on the number of implicated resources based on DetectedIssue.type; e.g. For drug-drug, there would be more than one. For timing, there would typically only be one.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.reasonReference rim: .outboundRelationship[typeCode=SUBJ].target[moodCode=EVN, INT]
DetectedIssue.evidence
Definition	Supporting evidence or manifestations that provide the basis for identifying the detected issue such as a GuidanceResponse or MeasureReport.
Cardinality	0...*
Type	BackboneElement
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.why[x]
DetectedIssue.evidence.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
DetectedIssue.evidence.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.
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
DetectedIssue.evidence.modifierExtension
Definition	May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality	0...*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
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.
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
DetectedIssue.evidence.code
Definition	A manifestation that led to the recording of this detected issue.
Cardinality	0...*
Type	CodeableConcept
Binding	Codes that describes the types of evidence for a detected issue. ManifestationAndSymptomCodes (example)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.why[x]
DetectedIssue.evidence.detail
Definition	Links to resources that constitute evidence for the detected issue such as a GuidanceResponse or MeasureReport.
Cardinality	0...*
Type	Reference(Resource)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.why[x]
DetectedIssue.detail
Definition	A textual explanation of the detected issue.
Cardinality	0...1
Type	string
Comments	Should focus on information not covered elsewhere as discrete data - no need to duplicate the narrative.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.note v2: AL1-5 / IAM-8 rim: .text
DetectedIssue.reference
Definition	The literature, knowledge-base or similar reference that describes the propensity for the detected issue identified.
Cardinality	0...1
Type	uri
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .outboundRelationship[typeCode=INST].target[classCode=ALRT, moodCode=DEFN].text.uri
DetectedIssue.mitigation
Definition	Indicates an action that has been taken or is committed to reduce or eliminate the likelihood of the risk identified by the detected issue from manifesting. Can also reflect an observation of known mitigating factors that may reduce/eliminate the need for any action.
Cardinality	0...*
Type	BackboneElement
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .outboundRelationship[typeCode=MITG].target[classCode=ACT, moodCode=EVN]
DetectedIssue.mitigation.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
DetectedIssue.mitigation.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.
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
DetectedIssue.mitigation.modifierExtension
Definition	May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality	0...*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
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.
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
DetectedIssue.mitigation.action
Definition	Describes the action that was taken or the observation that was made that reduces/eliminates the risk associated with the identified issue.
Cardinality	1...1
Type	CodeableConcept
Binding	Codes describing steps taken to resolve the issue or other circumstances that mitigate the risk associated with the issue; e.g. 'added concurrent therapy', 'prior therapy documented', etc. DetectedIssueMitigationAction (preferred)
Comments	The "text" component can be used for detail or when no appropriate code exists.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .code
DetectedIssue.mitigation.date
Definition	Indicates when the mitigating action was documented.
Cardinality	0...1
Type	dateTime
Comments	This might not be the same as when the mitigating step was actually taken.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .effectiveTime
DetectedIssue.mitigation.author
Definition	Identifies the practitioner who determined the mitigation and takes responsibility for the mitigation step occurring.
Cardinality	0...1
Type	Reference(Practitioner \| PractitionerRole)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .participation[typeCode=AUT].role[classCode=ASSIGNED]

<StructureDefinition xmlns="http://hl7.org/fhir">
    <url value="http://electronichealth.se/fhir/StructureDefinition/NLLDetectedIssue" />
    <version value="1.0.0" />
    <name value="NLLDetectedIssue" />
    <status value="active" />
    <date value="2022-02-02" />
    <publisher value="Swedish eHealth Agency" />
    <fhirVersion value="4.0.1" />
    <mapping>
        <identity value="workflow" />
        <uri value="http://hl7.org/fhir/workflow" />
        <name value="Workflow Pattern" />
    </mapping>
    <mapping>
        <identity value="v2" />
        <uri value="http://hl7.org/v2" />
        <name value="HL7 v2 Mapping" />
    </mapping>
    <mapping>
        <identity value="rim" />
        <uri value="http://hl7.org/v3" />
        <name value="RIM Mapping" />
    </mapping>
    <mapping>
        <identity value="w5" />
        <uri value="http://hl7.org/fhir/fivews" />
        <name value="FiveWs Pattern Mapping" />
    </mapping>
    <mapping>
        <identity value="EHM" />
        <name value="E-h&#228;lsomyndigheten concept" />
    </mapping>
    <kind value="resource" />
    <abstract value="false" />
    <type value="DetectedIssue" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DetectedIssue" />
    <derivation value="constraint" />
    <differential>
        <element id="DetectedIssue">
            <path value="DetectedIssue" />
            <short value="Issue according to Automatic Format and Constitution Control (AFF)" />
            <definition value="Indicates a issue with a MedcationRequest or a MedicationDispense according to the Automatic Format and Constitution Control (AFF) ." />
        </element>
        <element id="DetectedIssue.extension">
            <path value="DetectedIssue.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <rules value="open" />
            </slicing>
            <min value="0" />
        </element>
        <element id="DetectedIssue.extension:nllDispatchRowNo">
            <path value="DetectedIssue.extension" />
            <sliceName value="nllDispatchRowNo" />
            <short value="Identifier for MedicationDispense within dispatch" />
            <definition value="Used when communicationg an error or warning for a MedicationDispense within a dispatch. The DispatchRowNo (sv Akt&#246;rens expeditionsradnummer) uniquely identifies a MediationDispense within a dispatch." />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="http://electronichealth.se/fhir/StructureDefinition/NLLDispatchRowNo" />
            </type>
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="Akt&#246;rens expeditionsradnummer" />
            </mapping>
        </element>
        <element id="DetectedIssue.status">
            <path value="DetectedIssue.status" />
            <short value="preliminary" />
            <definition value="Indicates the status of the detected issue.\nThe status &quot;preliminary&quot; is used for in the Swedish National Medication List as the detected issues always are generated from the current conditions." />
            <mustSupport value="true" />
            <binding>
                <strength value="required" />
                <valueSet value="http://electronichealth.se/fhir/ValueSet/detected-issue-status" />
            </binding>
            <mapping>
                <identity value="EHM" />
                <map value="Status p&#229; avvikelse" />
            </mapping>
        </element>
        <element id="DetectedIssue.code">
            <path value="DetectedIssue.code" />
            <short value="AFF error or warning" />
            <definition value="Code identifying the Automatic Format and Constitution Control (AFF) error or warning." />
            <min value="1" />
            <mustSupport value="true" />
            <binding>
                <strength value="required" />
                <description value="Codes identifying the Automatic Format and Constitution Control (AFF) error or warning" />
                <valueSet value="http://ehalsomyndigheten.se/fhir/ValueSet/aff-codes" />
            </binding>
            <mapping>
                <identity value="EHM" />
                <map value="AFF-resultat" />
            </mapping>
        </element>
        <element id="DetectedIssue.code.coding">
            <path value="DetectedIssue.code.coding" />
            <min value="1" />
            <max value="1" />
            <mustSupport value="true" />
        </element>
        <element id="DetectedIssue.code.coding.system">
            <path value="DetectedIssue.code.coding.system" />
            <mustSupport value="true" />
        </element>
        <element id="DetectedIssue.code.coding.version">
            <path value="DetectedIssue.code.coding.version" />
            <mustSupport value="true" />
        </element>
        <element id="DetectedIssue.code.coding.code">
            <path value="DetectedIssue.code.coding.code" />
            <short value="Issue code" />
            <definition value="A code identifying the reason of the issue" />
            <min value="1" />
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="AFF-felkod" />
            </mapping>
        </element>
        <element id="DetectedIssue.code.coding.display">
            <path value="DetectedIssue.code.coding.display" />
            <short value="Error description" />
            <definition value="A short text describing the meaning of the error code" />
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="AFF-felmeddelande" />
            </mapping>
        </element>
        <element id="DetectedIssue.severity">
            <path value="DetectedIssue.severity" />
            <short value="moderate | low" />
            <definition value="In the Swedish National Medication List there are two severety levels: \n&quot;Low&quot; which corresponds to &quot;Accepted with a warning&quot; (Accepterad med varning)\nor\n&quot;Moderate&quot; which corresponds to &quot;Rejected&quot; (Avvisad)" />
            <mustSupport value="true" />
            <binding>
                <strength value="required" />
                <valueSet value="http://electronichealth.se/fhir/ValueSet/detected-issue-severity" />
            </binding>
            <mapping>
                <identity value="EHM" />
                <map value="Allvarlighetsgrad" />
            </mapping>
        </element>
        <element id="DetectedIssue.identified[x]">
            <path value="DetectedIssue.identified[x]" />
            <short value="Date and time when identified" />
            <definition value="The date and time when the Automatic Format and Constitution Control (Automatisk format- och f&#246;rfattningskontroll, AFF) was made." />
            <type>
                <code value="dateTime" />
            </type>
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="Kontrolltidpunkt" />
            </mapping>
        </element>
    </differential>
</StructureDefinition>

{
    "resourceType": "StructureDefinition",
    "url": "http://electronichealth.se/fhir/StructureDefinition/NLLDetectedIssue",
    "version": "1.0.0",
    "name": "NLLDetectedIssue",
    "status": "active",
    "date": "2022-02-02",
    "publisher": "Swedish eHealth Agency",
    "fhirVersion": "4.0.1",
    "mapping":  [
        {
            "identity": "workflow",
            "uri": "http://hl7.org/fhir/workflow",
            "name": "Workflow Pattern"
        },
        {
            "identity": "v2",
            "uri": "http://hl7.org/v2",
            "name": "HL7 v2 Mapping"
        },
        {
            "identity": "rim",
            "uri": "http://hl7.org/v3",
            "name": "RIM Mapping"
        },
        {
            "identity": "w5",
            "uri": "http://hl7.org/fhir/fivews",
            "name": "FiveWs Pattern Mapping"
        },
        {
            "identity": "EHM",
            "name": "E-hälsomyndigheten concept"
        }
    ],
    "kind": "resource",
    "abstract": false,
    "type": "DetectedIssue",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/DetectedIssue",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "DetectedIssue",
                "path": "DetectedIssue",
                "short": "Issue according to Automatic Format and Constitution Control (AFF)",
                "definition": "Indicates a issue with a MedcationRequest or a MedicationDispense according to the Automatic Format and Constitution Control (AFF) ."
            },
            {
                "id": "DetectedIssue.extension",
                "path": "DetectedIssue.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "rules": "open"
                },
                "min": 0
            },
            {
                "id": "DetectedIssue.extension:nllDispatchRowNo",
                "path": "DetectedIssue.extension",
                "sliceName": "nllDispatchRowNo",
                "short": "Identifier for MedicationDispense within dispatch",
                "definition": "Used when communicationg an error or warning for a MedicationDispense within a dispatch. The DispatchRowNo (sv Aktörens expeditionsradnummer) uniquely identifies a MediationDispense within a dispatch.",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://electronichealth.se/fhir/StructureDefinition/NLLDispatchRowNo"
                        ]
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Aktörens expeditionsradnummer"
                    }
                ]
            },
            {
                "id": "DetectedIssue.status",
                "path": "DetectedIssue.status",
                "short": "preliminary",
                "definition": "Indicates the status of the detected issue.\nThe status \"preliminary\" is used for in the Swedish National Medication List as the detected issues always are generated from the current conditions.",
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "valueSet": "http://electronichealth.se/fhir/ValueSet/detected-issue-status"
                },
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Status på avvikelse"
                    }
                ]
            },
            {
                "id": "DetectedIssue.code",
                "path": "DetectedIssue.code",
                "short": "AFF error or warning",
                "definition": "Code identifying the Automatic Format and Constitution Control (AFF) error or warning.",
                "min": 1,
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "description": "Codes identifying the Automatic Format and Constitution Control (AFF) error or warning",
                    "valueSet": "http://ehalsomyndigheten.se/fhir/ValueSet/aff-codes"
                },
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "AFF-resultat"
                    }
                ]
            },
            {
                "id": "DetectedIssue.code.coding",
                "path": "DetectedIssue.code.coding",
                "min": 1,
                "max": "1",
                "mustSupport": true
            },
            {
                "id": "DetectedIssue.code.coding.system",
                "path": "DetectedIssue.code.coding.system",
                "mustSupport": true
            },
            {
                "id": "DetectedIssue.code.coding.version",
                "path": "DetectedIssue.code.coding.version",
                "mustSupport": true
            },
            {
                "id": "DetectedIssue.code.coding.code",
                "path": "DetectedIssue.code.coding.code",
                "short": "Issue code",
                "definition": "A code identifying the reason of the issue",
                "min": 1,
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "AFF-felkod"
                    }
                ]
            },
            {
                "id": "DetectedIssue.code.coding.display",
                "path": "DetectedIssue.code.coding.display",
                "short": "Error description",
                "definition": "A short text describing the meaning of the error code",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "AFF-felmeddelande"
                    }
                ]
            },
            {
                "id": "DetectedIssue.severity",
                "path": "DetectedIssue.severity",
                "short": "moderate | low",
                "definition": "In the Swedish National Medication List there are two severety levels: \n\"Low\" which corresponds to \"Accepted with a warning\" (Accepterad med varning)\nor\n\"Moderate\" which corresponds to \"Rejected\" (Avvisad)",
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "valueSet": "http://electronichealth.se/fhir/ValueSet/detected-issue-severity"
                },
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Allvarlighetsgrad"
                    }
                ]
            },
            {
                "id": "DetectedIssue.identified[x]",
                "path": "DetectedIssue.identified[x]",
                "short": "Date and time when identified",
                "definition": "The date and time when the Automatic Format and Constitution Control (Automatisk format- och författningskontroll, AFF) was made.",
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Kontrolltidpunkt"
                    }
                ]
            }
        ]
    }
}

DetectedIssue		..
DetectedIssue.extension		0..
DetectedIssue.extension	Extension	0..1
DetectedIssue.status		..
DetectedIssue.code		1..
DetectedIssue.code.coding		1..1
DetectedIssue.code.coding.system		..
DetectedIssue.code.coding.version		..
DetectedIssue.code.coding.code		1..
DetectedIssue.code.coding.display		..
DetectedIssue.severity		..
DetectedIssue.identified[x]	dateTime	..

Contained resources

References to this resource are based on a contained resource when

Case	Resources
AFF warnings when a prescription is retrieved (GET).	MedicationRequest
AFF errors or warnings may occur when creating (POST) or updating (PUT) a prescription. Note that AFF warnings on prescriptions are not dismissive; they are intended to alert the user to potential dispensing obstacles.	OperationOutcome
AFF errors or warnings may occur when creating or validating (POST) a dispense. Note that warnings for a dispense are dismissive. A warning can be accepted when a dispense is registered.	OperationOutcome
Accepted AFF-warnings when registering a dispense (POST)	MedicationDispense

For more information about references and contained resources see Resources - References.

Details

Description of all elements can be found here, Element descriptions.

Mapping of FHIR element names to the National Medication List names can be found here, Element language mappings.

Supported operations

HTTP methods

Operation	Supported	Comment
Search (GET, POST)	no
Insert (POST)	no
Update (PUT)	no
Delete (DEL)	no
Operation (GET, POST)	no

It is not possible to interact with this resource.

Query operations

There are no queries available for this resource.