Online Consultation to Community Pharmacy - Pilot Specification

This version is in draft and is currently being migrated from the GP Connect Access Record: Structured specification

Profile: CareConnect-List-1

Important: The requirements for this element are still to be determined.
clinicalSettingI0..1Extension(CodeableConcept)
warningCodeI0..*Extension(code)
relatedProblemHeaderI0..1Extension(Complex)
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ1..1uri
valueΣ1..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(CareConnect-Organization-1)
statusΣ ?!1..1codeBinding
modeΣ ?!1..1codeBinding
titleΣ0..1string
codeΣ0..1CodeableConceptBinding
subjectΣ I0..1Reference(Group | Device | CareConnect-Patient-1 | CareConnect-Location-1)
encounterI0..1Reference(CareConnect-Encounter-1)
dateΣ0..1dateTime
sourceΣ I0..1Reference(Device | CareConnect-Patient-1 | CareConnect-Practitioner-1)
orderedBy0..1CodeableConceptBinding
authorStringstring
authorReferenceReference(RelatedPerson | CareConnect-Patient-1 | CareConnect-Practitioner-1)
timeΣ0..1dateTime
text1..1string
flag0..1CodeableConcept
deleted?! I0..1boolean
date0..1dateTime
itemI1..1Reference(Resource)
emptyReasonI0..1CodeableConceptBinding
List
DefinitionA set of information summarized from a list of other resources.
Cardinality0...*
AliasCollection, WorkingList, Organizer
Invariants
  • dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-1:If the resource is contained in another resource, it SHALL NOT contain any narrative
    contained.text.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-3:If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
    contained.where(('#'+id in %resource.descendants().reference).not()).empty()
  • lst-2:The deleted flag can only be used if the mode of the list is "changes"
    mode = 'changes' or entry.deleted.empty()
  • lst-1:A list can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
Mappings
  • rim:Entity. Role, or Act
  • rim:Act[classCode<ORG,moodCode=EVN]
  • w5:infrastructure.documents
List.id
DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality0...1
Typeid
SummaryTrue
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
List.meta
DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
Cardinality0...1
TypeMeta
SummaryTrue
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
List.implicitRules
DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.
Cardinality0...1
Typeuri
ModifierTrue
SummaryTrue
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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
List.language
DefinitionThe base language in which the resource is written.
Cardinality0...1
Typecode
Binding

A human language.

Common Languages (extensible)
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() | (children().count() > id.count())
Mappings
  • rim:n/a
List.text
DefinitionA human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Cardinality0...1
TypeNarrative
Aliasnarrative, 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 in formation is added later.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
  • rim:Act.text?
List.contained
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.
Cardinality0...*
TypeResource
Aliasinline 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.

Mappings
  • rim:Entity. Role, or Act
  • rim:N/A
List.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
List.extension:clinicalSetting
DefinitionTo record the clinical setting of a problem list.
Cardinality0...1
TypeExtension(CodeableConcept)
Aliasextensions, 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() | (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
List.extension:warningCode
DefinitionTo capture warnings that the list may be incomplete.
Cardinality0...*
TypeExtension(code)
Aliasextensions, 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() | (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
List.extension:relatedProblemHeader
DefinitionRelated problem header condition (target).
Cardinality0...1
TypeExtension(Complex)
Aliasextensions, 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() | (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
List.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
List.identifier
DefinitionIdentifier for the List assigned for business purposes outside the context of FHIR.
Cardinality0...*
TypeIdentifier
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim:II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd:Identifier
  • rim:.id
  • w5:id
List.identifier.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
List.identifier.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
List.identifier.use
DefinitionThe purpose of this identifier.
Cardinality0...1
Typecode
Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)
ModifierTrue
SummaryTrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:N/A
  • rim:Role.code or implied by context
List.identifier.type
DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Cardinality0...1
TypeCodeableConcept
Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Identifier Type Codes (extensible)
SummaryTrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.

Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:CX.5
  • rim:Role.code or implied by context
List.identifier.system
DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique.
Cardinality1...1
Typeuri
SummaryTrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

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

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

http://www.acme.com/identifiers/patient


Mappings
  • rim:n/a
  • v2:CX.4 / EI-2-4
  • rim:II.root or Role.id.root
  • servd:./IdentifierType
List.identifier.value
DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system.
Cardinality1...1
Typestring
SummaryTrue
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension.

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

123456


Mappings
  • rim:n/a
  • v2:CX.1 / EI.1
  • rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd:./Value
List.identifier.period
DefinitionTime period during which identifier is/was valid for use.
Cardinality0...1
TypePeriod
SummaryTrue
Comments

This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • per-1:If present, start SHALL have a lower value than end
    start.empty() or end.empty() or (start <= end)
Mappings
  • rim:n/a
  • v2:DR
  • rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2:CX.7 + CX.8
  • rim:Role.effectiveTime or implied by context
  • servd:./StartDate and ./EndDate
List.identifier.assigner
DefinitionOrganization that issued/manages the identifier.
Cardinality0...1
TypeReference(CareConnect-Organization-1)
SummaryTrue
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:CX.4 / (CX.4,CX.9,CX.10)
  • rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd:./IdentifierIssuingAuthority
List.status
DefinitionIndicates the current state of this list.
Cardinality1...1
Typecode
Binding

The current state of the list

ListStatus (required)
ModifierTrue
SummaryTrue
Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.status[current=active;retired=obsolete;entered-in-error=nullified]
  • w5:status
List.mode
DefinitionHow this list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Cardinality1...1
Typecode
Binding

The processing mode that applies to this list

ListMode (required)
ModifierTrue
SummaryTrue
Requirements

Lists are used in various ways, and it must be known in what way it is safe to use them.

Comments

This element is labeled as a modifier because a change list must not be mis-understood as a complete list.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • w5:class
List.title
DefinitionA label for the list assigned by the author.
Cardinality0...1
Typestring
SummaryTrue
Requirements

Allows customization beyond just the code identifying the kind of list.

Comments

Note that FHIR strings may not exceed 1MB in size

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

Dr. Jane's Patients


Mappings
  • rim:n/a
  • rim:.title
List.code
DefinitionThis code defines the purpose of the list - why it was created.
Cardinality0...1
TypeCodeableConcept
Binding

What the purpose of a list is

Care Connect List Code (preferred)
SummaryTrue
Requirements

Lists often contain subsets of resources rather than an exhaustive list. The code identifies what type of subset is included.

Comments

If there is no code, the purpose of the list is implied where it is used, such as in a document section using Document.section.code.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:.code
  • w5:what
List.subject
DefinitionThe common subject (or patient) of the resources that are in the list, if there is one.
Cardinality0...1
TypeReference(Group | Device | CareConnect-Patient-1 | CareConnect-Location-1)
SummaryTrue
Requirements

The primary purpose of listing the subject explicitly is to help with finding the right list.

Comments

Some purely arbitrary lists do not have a common subject, so this is optional.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.participation[typeCode<SUB].role (and sometimes .player)
  • w5:who.focus
List.encounter
DefinitionThe encounter that is the context in which this list was created.
Cardinality0...1
TypeReference(CareConnect-Encounter-1)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
  • w5:context
List.date
DefinitionThe date that the list was prepared.
Cardinality0...1
TypedateTime
SummaryTrue
Requirements

Identifies how current the list is which affects relevance.

Comments

The actual important date is the date of currency of the resources that were summarized, but it is usually assumed that these are current when the preparation occurs.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.participation[typeCode<AUT].time[type=TS]
  • w5:when.recorded
List.source
DefinitionThe entity responsible for deciding what the contents of the list were. Where the list was created by a human, this is the same as the author of the list.
Cardinality0...1
TypeReference(Device | CareConnect-Patient-1 | CareConnect-Practitioner-1)
SummaryTrue
AliasAuthor
Requirements

Allows follow-up as well as context.

Comments

The primary source is the entity that made the decisions what items are in the list. This may be software or user.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.participation[typeCode<AUT].role[classCode=REL].player[classCode=PSN,determinerCode=INST] or .participation[typeCode<AUT].role[classCode=REL].player[classCode=DEV,determinerCode=INST]
  • w5:who.author
List.orderedBy
DefinitionWhat order applies to the items in the list.
Cardinality0...1
TypeCodeableConcept
Binding

What order applies to the items in a list

List Order Codes (preferred)
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:.outboundRelationship[typeCode=COMP].sequenceNumber > 1
List.note
DefinitionComments that apply to the overall list.
Cardinality0...*
TypeAnnotation
Comments

For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:N/A
  • rim:Act
  • rim:.inboundRelationship[typeCode=SUBJ].act.text
List.note.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
List.note.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
List.note.author[x]
DefinitionThe individual responsible for making the annotation.
Cardinality0...1
TypeReference(RelatedPerson | CareConnect-Patient-1 | CareConnect-Practitioner-1), string
SummaryTrue
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:N/A
  • rim:Act.participant[typeCode=AUT].role
List.note.time
DefinitionIndicates when this particular annotation was made.
Cardinality0...1
TypedateTime
SummaryTrue
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:N/A
  • rim:Act.effectiveTime
List.note.text
DefinitionThe text of the annotation.
Cardinality1...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:N/A
  • rim:Act.text
List.entry
DefinitionEntries in this list.
Cardinality0...*
TypeBackboneElement
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
List.entry.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
List.entry.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
List.entry.modifierExtension
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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
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() | (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
List.entry.flag
DefinitionThe flag allows the system constructing the list to indicate the role and significance of the item in the list.
Cardinality0...1
TypeCodeableConcept
Binding

Codes that provide further information about the reason and meaning of the item in the list

Patient Medicine Change Types (example)
Requirements

This field is present to support various clinical uses of lists, such as a discharge summary medication list, where flags specify whether the medication was added, modified, or deleted from the list.

Comments

The flag can only be understood in the context of the List.code. If the flag means that the entry has actually been deleted from the list, the deleted element SHALL be true. Deleted can only be used if the List.mode is "changes".

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:.outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
List.entry.deleted
DefinitionTrue if this item is marked as deleted in the list.
Cardinality0...1
Typeboolean
ModifierTrue
Requirements

The flag element may contain codes that an application processing the list does not understand. However there can be no ambiguity if a list item is actually marked as "deleted".

Comments

If the flag means that the entry has actually been deleted from the list, the deleted element SHALL be true. Both flag and deleted can only be used if the List.mode is "changes". A deleted entry should be displayed in narrative as deleted.

This element is labeled as a modifier because it indicates that an item is (to be) no longer in the list.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:added: .updateMode=("A","AR") retained: .updateMode="NC" updated: .updateMode="R" deleted: .updateMode="D"
List.entry.date
DefinitionWhen this item was added to the list.
Cardinality0...1
TypedateTime
Requirements

The date may be significant for understanding the meaning of items in a working list.

Comments

This is only useful and meaningful when the mode is "working".

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.availabilityTime
List.entry.item
DefinitionA reference to the actual resource from which data was derived.
Cardinality1...1
TypeReference(Resource)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.target or .role or .role.entity
List.emptyReason
DefinitionIf the list is empty, why the list is empty.
Cardinality0...1
TypeCodeableConcept
Binding

If a list is empty, why it is empty

Care Connect List Empty Reason Code (preferred)
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty list make a significant interpretation to its interpretation. Note that this code is for use when the entire list has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:.inboundRelationship[typeCode=SUBJ,code<{ListEmptyReason}].value[type=CD]

Population guidance

  • a List containing references to all Observation resources that are captured MUST be populated if coded Observations are being sent (the List resource in FHIR is used to manage collections of resources)
  • the status element MUST contain a fixed value of current
  • the mode element MUST contain a fixed value of snapshot
  • the title element MUST contain the display element from the code field
  • the code element MUST contain 826501000000100 - Miscellaneous record
  • the subject element MUST reference the Patient profile representing the Patient against whom the data was recorded
  • the entry.item element MUST be populated to reference any/all Observation in the message
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