| BodyStructure | C | | DomainResource | Element idBodyStructure Short descriptionSpecific and identified anatomical structure Alternate namesanatomical location DefinitionRecord details about an anatomical structure. This resource may be used when a coded concept does not provide the necessary detail needed for the use case.
DomainResource Constraints- dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.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 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-6: A resource should have narrative for robust management
text.`div`.exists() - dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
contained.meta.security.empty()
Mappings- rim: Entity. Role, or Act
- rim: ActSIte
- openehr: Archetype ID openEHR-EHR-CLUSTER.anatomical_location.v1 Concept name Anatomical Location Concept description Record details about an anatomical location. Keywords location, site, anatomical Copyright © openEHR Foundation Purpose To record details about anatomical location. Misuse Not for specifiying unilateral/bilateral occurrence - this is related to an evaluation which perhaps includes multiple locations. Author Author name: Heather Leslie Organization: Ocean Informatics Email: heather.leslie@oceaninformatics.com Date of Origination: 2008-11-10 Translator Norwegian Bokmål: Lars Bitsch-Larsen, Haukeland University Hospital of Bergen, Norway, MD, DEAA, MBA, spec in anesthesia, spec in tropical medicine. Arabic (Syria): Mona Saleh Other contributors Heather Leslie, Ocean Informatics, Australia (Editor) Ian McNicoll, freshEHR Clinical Informatics, United Kingdom (Editor) Dunmail Hodkinson, Black Pear Software Ltd, UK References Use cases: - 5LICS, midclavicular line - L forearm, 2cm anterior to the cubital fossa - Right iliac fossa - 5 cm below L tibial tuberosity - 2 cm medial to R nipple - 4 cm below R costal margin in midclavicular line - R femur - midline nose - medial aspect of R great toe nail.
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| id | Σ | 0..1 | string | There are no (further) constraints on this element Element idBodyStructure.id Short descriptionLogical 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.
string |
| meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idBodyStructure.meta Short descriptionMetadata 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.
Meta ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
| implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idBodyStructure.implicitRules Short descriptionA 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.
uri ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
| language | | 0..1 | codeBinding | There are no (further) constraints on this element Element idBodyStructure.language Short descriptionLanguage 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).
code BindingCommonLanguages (preferred) Binding extensionsConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
| text | | 0..1 | Narrative | There are no (further) constraints on this element Element idBodyStructure.text Short descriptionText 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.
Narrative ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- rim: N/A
- rim: Act.text?
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| contained | | 0..* | Resource | There are no (further) constraints on this element Element idBodyStructure.contained Short descriptionContained, 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.
Resource Mappings- rim: Entity. Role, or Act
- rim: N/A
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idBodyStructure.extension Short descriptionAdditional 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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| modifierExtension | ?! C | 0..* | Extension | There are no (further) constraints on this element Element idBodyStructure.modifierExtension Short descriptionExtensions 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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| identifier | Σ | 0..* | Identifier | Element idBodyStructure.identifier Short descriptionBodystructure identifier DefinitionIdentifier for this instance of the anatomical structure.
Identifier ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim: II - 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
- w5: FiveWs.identifier
- rim: .id
- openehr: Specific location Cluster Optional (0..1) Cardinality: Mandatory, repeating, unordered (1..*)
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| active | Σ ?! | 0..1 | boolean | Element idBodyStructure.active Short descriptionWhether this record is in active use DefinitionWhether this body site is in active use.
Need to be able to mark a body site entry as not to be used because it was created in error.
This element is labeled as a modifier because it may be used to mark that the resource was created in error.
This resource is generally assumed to be active if no value is provided for the active element
boolean ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- w5: FiveWs.status
- rim: statusCode
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| morphology | Σ | 0..1 | CodeableConcept | Element idBodyStructure.morphology Short descriptionKind of Structure DefinitionThe kind of structure being represented by the body structure at BodyStructure.location. This can define both normal and abnormal morphologies.
The minimum cardinality of 0 supports the use case of specifying a location without defining a morphology.
CodeableConcept BindingCodes describing anatomic morphology.
SNOMEDCTMorphologicAbnormalities (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- w5: FiveWs.what[x]
- v2: SPM-4/SPM-5
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| location | Σ | 0..1 | CodeableConcept | Element idBodyStructure.location Short descriptionBody site DefinitionThe anatomical location or region of the specimen, lesion, or body structure.
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.
CodeableConcept BindingCodes describing anatomical locations. May include laterality.
SNOMEDCTBodyStructures (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- w5: FiveWs.what[x]
- v2: OBX-20/SPM-8/SPM-10
- rim: .targetSiteCode
- openehr: Name of location
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| locationQualifier | | 0..* | CodeableConcept | Element idBodyStructure.locationQualifier Short descriptionBody site modifier DefinitionQualifier to refine the anatomical location. These include qualifiers for laterality, relative location, directionality, number, and plane.
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.
CodeableConcept BindingConcepts modifying the anatomic location.
BodystructureLocationQualifier (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- w5: FiveWs.what[x]
- v2: No distinct element defined in V2.x. The IHE Radiology Technical Framework directs the use of OBR-15-specimen source to contain laterality for imaging studies./SPM-9
- rim: .targetSiteCode
- openehr: Combines Side, Numerical identifier, Anatomical plane,and Aspect
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| description | Σ | 0..1 | string | Element idBodyStructure.description Short descriptionText description DefinitionA summary, characterization or explanation of the body structure.
This description could include any visual markings used to orientate the viewer e.g. external reference points, special sutures, ink markings.
string ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- w5: FiveWs.what[x]
- v2: NTE
- rim: .text
- openehr: Description of anatomical location/Visual markings/orientation
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| image | C | 0..* | Attachment | Element idBodyStructure.image Short descriptionAttached images DefinitionImage or images used to identify a location.
When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Signed Procedure Consent".
Attachment ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - att-1: If the Attachment has data, it SHALL have a contentType
data.empty() or contentType.exists()
Mappings- rim: n/a
- v2: ED/RP
- rim: ED
- w5: FiveWs.what[x]
- v2: OBX
- rim: outboundRelationship[typeCode=COMP].target
- openehr: Image
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| patient | Σ C | 1..1 | Reference(Patient) | Element idBodyStructure.patient Short descriptionWho this is about DefinitionThe person to which the body site belongs.
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(Patient) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- w5: FiveWs.subject[x]
- v2: PID-3
- rim: .scoper or .scoper.playsRole
- w5: FiveWs.subject
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