Page Status: updated 2022-03-04
DetectedIssue
Page index
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 idDetectedIssue Issue according to Automatic Format and Constitution Control (AFF) Alternate namesDDI, drug-drug interaction, Contraindication, Alert DefinitionIndicates a issue with a MedcationRequest or a MedicationDispense according to the Automatic Format and Constitution Control (AFF) .
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id | Σ | 0..1 | string | There are no (further) constraints on this element Element idDetectedIssue.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idDetectedIssue.meta Metadata about the resource DefinitionThe 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.
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implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idDetectedIssue.implicitRules A set of rules under which this content was created DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. 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.
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language | 0..1 | codeBinding | There are no (further) constraints on this element Element idDetectedIssue.language Language of the resource content DefinitionThe base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language.
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text | 0..1 | Narrative | There are no (further) constraints on this element Element idDetectedIssue.text Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA human-readable narrative that contains a summary of the resource and 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. 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.
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contained | 0..* | Resource | There are no (further) constraints on this element Element idDetectedIssue.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
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extension | I | 0..* | Extension | Element idDetectedIssue.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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nllDispatchRowNo | S I | 0..1 | Extension(decimal) | Element idDetectedIssue.extension:nllDispatchRowNo Identifier for MedicationDispense within dispatch Alternate namesextensions, user content DefinitionUsed when communicationg an error or warning for a MedicationDispense within a dispatch. The DispatchRowNo (sv Aktörens expeditionsradnummer) uniquely identifies a MediationDispense within a dispatch. 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. http://electronichealth.se/fhir/StructureDefinition/NLLDispatchRowNo Constraints
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modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idDetectedIssue.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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). 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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identifier | Σ | 0..* | Identifier | There are no (further) constraints on this element Element idDetectedIssue.identifier Unique id for the detected issue DefinitionBusiness identifier associated with the detected issue record. Allows linking instances of the same detected issue found on different servers.
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status | S Σ ?! | 1..1 | codeBinding | Element idDetectedIssue.status preliminary Alternate namesstatus DefinitionIndicates 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. 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. Indicates the status of the identified issue.
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code | S Σ | 1..1 | CodeableConceptBinding | Element idDetectedIssue.code AFF error or warning Alternate namestype DefinitionCode identifying the Automatic Format and Constitution Control (AFF) error or warning. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Codes identifying the Automatic Format and Constitution Control (AFF) error or warning
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id | 0..1 | string | There are no (further) constraints on this element Element idDetectedIssue.code.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idDetectedIssue.code.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | S Σ | 1..1 | Coding | There are no (further) constraints on this element Element idDetectedIssue.code.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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.
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id | 0..1 | string | There are no (further) constraints on this element Element idDetectedIssue.code.coding.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idDetectedIssue.code.coding.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element idDetectedIssue.code.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
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version | S Σ | 0..1 | string | There are no (further) constraints on this element Element idDetectedIssue.code.coding.version Version of the system - if relevant DefinitionThe 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. 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.
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code | S Σ | 1..1 | code | Element idDetectedIssue.code.coding.code Issue code DefinitionA code identifying the reason of the issue Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 0..1 | string | Element idDetectedIssue.code.coding.display Error description DefinitionA short text describing the meaning of the error code Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idDetectedIssue.code.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idDetectedIssue.code.text Plain text representation of the concept DefinitionA 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. 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. Very often the text is the same as a displayName of one of the codings.
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severity | S Σ | 0..1 | codeBinding | Element idDetectedIssue.severity moderate | low Alternate namesseverity DefinitionIn 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) Note that FHIR strings SHALL NOT exceed 1MB in size Indicates the potential degree of impact of the identified issue on the patient.
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patient | Σ I | 0..1 | Reference(Patient) | There are no (further) constraints on this element Element idDetectedIssue.patient Associated patient DefinitionIndicates the patient whose record the detected issue is associated with. 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. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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identified[x] | S Σ | 0..1 | Element idDetectedIssue.identified[x] Date and time when identified DefinitionThe date and time when the Automatic Format and Constitution Control (Automatisk format- och författningskontroll, AFF) was made. No-one can be responsible for mitigation prior to the issue being identified.
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identifiedDateTime | dateTime | Data type | ||
author | Σ I | 0..1 | Reference(Practitioner | PractitionerRole | Device) | There are no (further) constraints on this element Element idDetectedIssue.author The provider or device that identified the issue DefinitionIndividual or device responsible for the issue being raised. For example, a decision support application or a pharmacist conducting a medication review. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Practitioner | PractitionerRole | Device) Constraints
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implicated | Σ I | 0..* | Reference(Resource) | There are no (further) constraints on this element Element idDetectedIssue.implicated Problem resource Alternate namescause DefinitionIndicates the resource representing the current activity or proposed activity that is potentially problematic. 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.
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evidence | 0..* | BackboneElement | There are no (further) constraints on this element Element idDetectedIssue.evidence Supporting evidence DefinitionSupporting evidence or manifestations that provide the basis for identifying the detected issue such as a GuidanceResponse or MeasureReport.
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id | 0..1 | string | There are no (further) constraints on this element Element idDetectedIssue.evidence.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idDetectedIssue.evidence.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idDetectedIssue.evidence.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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.
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code | 0..* | CodeableConcept | There are no (further) constraints on this element Element idDetectedIssue.evidence.code Manifestation DefinitionA manifestation that led to the recording of this detected issue. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Codes that describes the types of evidence for a detected issue.
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detail | I | 0..* | Reference(Resource) | There are no (further) constraints on this element Element idDetectedIssue.evidence.detail Supporting information DefinitionLinks to resources that constitute evidence for the detected issue such as a GuidanceResponse or MeasureReport. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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detail | 0..1 | string | There are no (further) constraints on this element Element idDetectedIssue.detail Description and context DefinitionA textual explanation of the detected issue. Should focus on information not covered elsewhere as discrete data - no need to duplicate the narrative.
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reference | 0..1 | uri | There are no (further) constraints on this element Element idDetectedIssue.reference Authority for issue DefinitionThe literature, knowledge-base or similar reference that describes the propensity for the detected issue identified. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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mitigation | 0..* | BackboneElement | There are no (further) constraints on this element Element idDetectedIssue.mitigation Step taken to address DefinitionIndicates 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.
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id | 0..1 | string | There are no (further) constraints on this element Element idDetectedIssue.mitigation.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idDetectedIssue.mitigation.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idDetectedIssue.mitigation.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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.
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action | 1..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idDetectedIssue.mitigation.action What mitigation? DefinitionDescribes the action that was taken or the observation that was made that reduces/eliminates the risk associated with the identified issue. The "text" component can be used for detail or when no appropriate code exists. 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.
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date | 0..1 | dateTime | There are no (further) constraints on this element Element idDetectedIssue.mitigation.date Date committed DefinitionIndicates when the mitigating action was documented. This might not be the same as when the mitigating step was actually taken.
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author | I | 0..1 | Reference(Practitioner | PractitionerRole) | There are no (further) constraints on this element Element idDetectedIssue.mitigation.author Who is committing? DefinitionIdentifies the practitioner who determined the mitigation and takes responsibility for the mitigation step occurring. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Practitioner | PractitionerRole) Constraints
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Contained resources
References to this resource are based on a contained resource when TODO.
Case | Resources |
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AFF warnings when creating | MedicationRequest, OperationOutcome |
AFF errors when creating | OperationOutcome |
AFF issues when dispense (request) | MedicationDispense |
AFF issues when dispense (response) | OperationOutcome |
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 |
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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.