GP Connect - Update Record (ITK3)

• 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()

• rim:Entity. Role, or Act
• v2:Partial mapping for problem evaluation
• w5:clinical.general

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

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

• rim:n/a

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

• rim:n/a
• rim:N/A

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.

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

• rim:n/a

A human language.

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).

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

• rim:n/a

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.

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

• rim:n/a
• rim:N/A
• rim:Act.text?

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.

• rim:Entity. Role, or Act
• rim:N/A

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.

• 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()

• rim:n/a
• rim:N/A

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.

• 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()

• rim:n/a
• rim:N/A

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

• 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
• v2:PID-3
• w5:id

Note that FHIR strings may not exceed 1MB in size

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

• rim:n/a

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.

• 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()

• rim:n/a
• rim:N/A

Identifies the purpose for this identifier, if known .

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

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.

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

• rim:n/a
• v2:N/A
• rim:Role.code or implied by context

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

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

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.

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

• 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

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.

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

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

• rim:n/a
• v2:CX.4 / EI-2-4
• rim:II.root or Role.id.root
• servd:./IdentifierType

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.

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

• 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

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.

• 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)

• 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

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.

• 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'))

• 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

The workflow state of a clinical impression.

This element is labeled as a modifier because the status contains the code entered-in-error that marks the clinical impression as not currently valid.

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

• rim:n/a
• v2:PRB-14
• w5:status

Identifies categories of clinical impressions. This is a place-holder only. It may be removed

This is present as a place-holder only and may be removed based on feedback/work group opinion.

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

• rim:n/a
• v2:CE/CNE/CWE
• rim:CD
• orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
• w5:what

Note that FHIR strings may not exceed 1MB in size

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

• rim:n/a

Group is typically for veterinary and/or public health 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.

• 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'))

• rim:n/a
• rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
• v2:PID-3
• w5:who.focus

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.

• 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'))

• rim:n/a
• rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
• w5:context

This SHOULD be accurate to at least the minute, though some assessments only have a known date.

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

• rim:n/a
• v2:PRB-2
• w5:when.done

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

• rim:n/a
• w5:when.recorded

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.

• 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'))

• rim:n/a
• rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
• v2:ROL-4
• w5:who.author

It is always likely that multiple previous assessments exist for a patient. The point of quoting a previous assessment is that this assessment is relative to it (see resolved).

• 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'))

• rim:n/a
• rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)

e.g. The patient is a pregnant, and cardiac congestive failure, ‎Adenocarcinoma, and is allergic to penicillin.

• 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'))

• rim:n/a
• rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
• v2:PRB-3 / IAM-7
• w5:why

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

• rim:n/a

Note that FHIR strings may not exceed 1MB in size

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

• rim:n/a

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.

• 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()

• rim:n/a
• rim:N/A

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.

• 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()

• rim:n/a
• rim:N/A

A name/code for a set of investigations.

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.

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

• rim:n/a
• v2:CE/CNE/CWE
• rim:CD
• orim:fhir:CodeableConcept rdfs:subClassOf dt:CD

Most investigations are observations of one kind of or another but some other specific types of data collection resources can also be used.

• 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'))

• rim:n/a
• rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
• v2:OBX-21

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

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

• rim:n/a

Note that FHIR strings may not exceed 1MB in size

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

• rim:n/a
• v2:OBX

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

• rim:n/a

Note that FHIR strings may not exceed 1MB in size

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

• rim:n/a

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.

• 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()

• rim:n/a
• rim:N/A

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.

• 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()

• rim:n/a
• rim:N/A

Identification of the Condition or diagnosis.

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

• rim:n/a
• v2:OBX

Note that FHIR strings may not exceed 1MB in size

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

• rim:n/a

Prognosis or outlook findings

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.

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

• rim:n/a
• v2:CE/CNE/CWE
• rim:CD
• orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
• v2:PRB-22

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.

• 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'))

• rim:n/a
• rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)

Actions recommended as a result of the impression should not be captured using the 'action' element.

• 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'))

• rim:n/a
• rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)

Don't use this element for content that should more properly appear as one of the specific elements of the impression.

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

• rim:n/a
• v2:N/A
• rim:Act