Maia Rule Based Evaluation
Tiplu presumed diagnoses are generated and displayed based on a set of rules derived from medical guidelines and literature (state-of-the-art medicine).
Customised presumptive diagnoses can be created and released to all MAIA users in the hospital by physicians trained by the manufacturer, known as Medical Administrators, using a rules editor built into MAIA. These function similarly to Tiplu presumed diagnoses, but additionally provide the option to include therapy and diagnostic information. Medical administrators can enable/disable these rules only for patients within the departments for which they have access rights.
German: Tiplu-Verdachtsdiagnosen werden auf der Grundlage eines von Leitlinien und Fachliteratur (State-of-the-Art Medizin) basierenden Regelwerkes generiert und angezeigt.
Vom Hersteller geschulte Ärzte, so genannte Medical Administrators, können mithilfe eines in MAIA integrierten Regeleditors benutzerdefinierte Verdachtsdiagnosen erstellen und für alle MAIA-Benutzer im Krankenhaus freigeben. Diese funktionieren analog zu Tiplu-Verdachtsdiagnosen, bieten jedoch zusätzlich die Möglichkeit, Therapie- und Diagnostikinformationen zu hinterlegen. Medizinische Administrator:innen können dabei entsprechende Hinweise nur für Patient:innen der Fachabteilungen aktivieren/deaktivieren, auf deren Patient:innen sie ein Zugriffsrecht haben.
Metadaten
| Canonical | https://tiplu.de/fhir/maia/StructureDefinition/MaiaRuleBasedEvaluation |
|---|---|
| Status | active |
| Version | 1.0.0 |
| Basis | http://hl7.org/fhir/StructureDefinition/RiskAssessment |
Inhalt
| MaiaRuleBasedEvaluation (RiskAssessment) | C | RiskAssessment | |
| id | Σ | 0..1 | string |
| meta | Σ | 0..1 | Meta |
| implicitRules | Σ ?! | 0..1 | uri |
| language | 0..1 | codeBinding | |
| text | S | 0..1 | Narrative |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| status | S | 1..1 | codeBinding |
| div | S C | 1..1 | xhtml |
| contained | 0..* | Resource | |
| extension | C | 2..* | Extension |
| ReviewStatus | S C | 1..1 | Extension(Coding) |
| id | 0..1 | string | |
| extension | C | 0..0 | Extension |
| url | 1..1 | uriFixed Value | |
| value[x] | S | 0..1 | Binding |
| valueCoding | Coding | ||
| DefinitionReference | S C | 1..1 | Extension |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| url | 1..1 | uriFixed Value | |
| value[x] | S | 0..1 | |
| valueAddress | Address | ||
| valueAge | Age | ||
| valueAnnotation | Annotation | ||
| valueAttachment | Attachment | ||
| valueBase64Binary | base64Binary | ||
| valueBoolean | boolean | ||
| valueCanonical | canonical | ||
| valueCode | code | ||
| valueCodeableConcept | CodeableConcept | ||
| valueCoding | Coding | ||
| valueContactDetail | ContactDetail | ||
| valueContactPoint | ContactPoint | ||
| valueContributor | Contributor | ||
| valueCount | Count | ||
| valueDataRequirement | DataRequirement | ||
| valueDate | date | ||
| valueDateTime | dateTime | ||
| valueDecimal | decimal | ||
| valueDistance | Distance | ||
| valueDosage | Dosage | ||
| valueDuration | Duration | ||
| valueExpression | Expression | ||
| valueHumanName | HumanName | ||
| valueId | id | ||
| valueIdentifier | Identifier | ||
| valueInstant | instant | ||
| valueInteger | integer | ||
| valueMarkdown | markdown | ||
| valueMeta | Meta | ||
| valueMoney | Money | ||
| valueOid | oid | ||
| valueParameterDefinition | ParameterDefinition | ||
| valuePeriod | Period | ||
| valuePositiveInt | positiveInt | ||
| valueQuantity | Quantity | ||
| valueRange | Range | ||
| valueRatio | Ratio | ||
| valueReference | Reference | ||
| valueRelatedArtifact | RelatedArtifact | ||
| valueSampledData | SampledData | ||
| valueSignature | Signature | ||
| valueString | string | ||
| valueTime | time | ||
| valueTiming | Timing | ||
| valueTriggerDefinition | TriggerDefinition | ||
| valueUnsignedInt | unsignedInt | ||
| valueUri | uri | ||
| valueUrl | url | ||
| valueUsageContext | UsageContext | ||
| valueUuid | uuid | ||
| modifierExtension | ?! C | 0..* | Extension |
| HiddenReason | S ?! C | 0..1 | Extension |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| url | 1..1 | uri | |
| value[x] | S | 0..1 | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| Reason | S | ||
| text | S | ||
| valueAddress | Address | ||
| valueAge | Age | ||
| valueAnnotation | Annotation | ||
| valueAttachment | Attachment | ||
| valueBase64Binary | base64Binary | ||
| valueBoolean | boolean | ||
| valueCanonical | canonical | ||
| valueCode | code | ||
| valueCodeableConcept | CodeableConcept | ||
| valueCoding | Coding | ||
| valueContactDetail | ContactDetail | ||
| valueContactPoint | ContactPoint | ||
| valueContributor | Contributor | ||
| valueCount | Count | ||
| valueDataRequirement | DataRequirement | ||
| valueDate | date | ||
| valueDateTime | dateTime | ||
| valueDecimal | decimal | ||
| valueDistance | Distance | ||
| valueDosage | Dosage | ||
| valueDuration | Duration | ||
| valueExpression | Expression | ||
| valueHumanName | HumanName | ||
| valueId | id | ||
| valueIdentifier | Identifier | ||
| valueInstant | instant | ||
| valueInteger | integer | ||
| valueMarkdown | markdown | ||
| valueMeta | Meta | ||
| valueMoney | Money | ||
| valueOid | oid | ||
| valueParameterDefinition | ParameterDefinition | ||
| valuePeriod | Period | ||
| valuePositiveInt | positiveInt | ||
| valueQuantity | Quantity | ||
| valueRange | Range | ||
| valueRatio | Ratio | ||
| valueReference | Reference | ||
| valueRelatedArtifact | RelatedArtifact | ||
| valueSampledData | SampledData | ||
| valueSignature | Signature | ||
| valueString | string | ||
| valueTime | time | ||
| valueTiming | Timing | ||
| valueTriggerDefinition | TriggerDefinition | ||
| valueUnsignedInt | unsignedInt | ||
| valueUri | uri | ||
| valueUrl | url | ||
| valueUsageContext | UsageContext | ||
| valueUuid | uuid | ||
| identifier | Σ | 0..* | Identifier |
| basedOn | C | 0..1 | Reference(Resource) |
| parent | C | 0..1 | Reference(MaiaRuleBasedEvaluation) |
| status | S Σ | 1..1 | codeBinding |
| method | S Σ | 1..1 | CodeableConcept |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| coding | S Σ | 1..* | Coding |
| AssessmentMethod | S Σ | 1..1 | CodingBindingPattern |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| system | S Σ | 1..1 | uriPattern |
| version | Σ | 0..1 | string |
| code | S Σ | 1..1 | codePattern |
| display | S Σ | 1..1 | stringPattern |
| userSelected | Σ | 0..1 | boolean |
| text | Σ | 0..1 | string |
| code | S Σ C | 1..1 | CodeableConcept |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| coding | S Σ | 0..* | Coding |
| AssessmentType | S Σ | 0..1 | CodingBinding |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| system | S Σ | 1..1 | uri |
| version | Σ | 0..1 | string |
| code | S Σ | 1..1 | code |
| display | S Σ | 1..1 | string |
| userSelected | Σ | 0..1 | boolean |
| text | S Σ | 0..1 | string |
| subject | S Σ C | 1..1 | Reference(MaiaPatient) |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| reference | Σ C | 0..1 | string |
| type | Σ | 0..1 | uriBinding |
| identifier | S Σ | 1..1 | IdentifierPid |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| use | Σ ?! | 0..1 | codeBinding |
| type | S Σ | 1..1 | CodeableConceptBindingPattern |
| system | S Σ | 1..1 | uri |
| value | S Σ | 1..1 | string |
| period | Σ C | 0..1 | Period |
| assigner | Σ C | 0..1 | Reference(Organization) |
| display | Σ | 0..1 | string |
| encounter | S Σ C | 1..1 | Reference(MaiaKontaktGesundheitseinrichtung) |
| id | 0..1 | string | |
| extension | C | 1..* | Extension |
| AccountIdentifier | S C | 1..1 | Extension |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| url | 1..1 | uriFixed Value | |
| value[x] | S | 0..1 | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| type | S | ||
| system | S | ||
| value | S | ||
| valueAddress | Address | ||
| valueAge | Age | ||
| valueAnnotation | Annotation | ||
| valueAttachment | Attachment | ||
| valueBase64Binary | base64Binary | ||
| valueBoolean | boolean | ||
| valueCanonical | canonical | ||
| valueCode | code | ||
| valueCodeableConcept | CodeableConcept | ||
| valueCoding | Coding | ||
| valueContactDetail | ContactDetail | ||
| valueContactPoint | ContactPoint | ||
| valueContributor | Contributor | ||
| valueCount | Count | ||
| valueDataRequirement | DataRequirement | ||
| valueDate | date | ||
| valueDateTime | dateTime | ||
| valueDecimal | decimal | ||
| valueDistance | Distance | ||
| valueDosage | Dosage | ||
| valueDuration | Duration | ||
| valueExpression | Expression | ||
| valueHumanName | HumanName | ||
| valueId | id | ||
| valueIdentifier | Identifier | ||
| valueInstant | instant | ||
| valueInteger | integer | ||
| valueMarkdown | markdown | ||
| valueMeta | Meta | ||
| valueMoney | Money | ||
| valueOid | oid | ||
| valueParameterDefinition | ParameterDefinition | ||
| valuePeriod | Period | ||
| valuePositiveInt | positiveInt | ||
| valueQuantity | Quantity | ||
| valueRange | Range | ||
| valueRatio | Ratio | ||
| valueReference | Reference | ||
| valueRelatedArtifact | RelatedArtifact | ||
| valueSampledData | SampledData | ||
| valueSignature | Signature | ||
| valueString | string | ||
| valueTime | time | ||
| valueTiming | Timing | ||
| valueTriggerDefinition | TriggerDefinition | ||
| valueUnsignedInt | unsignedInt | ||
| valueUri | uri | ||
| valueUrl | url | ||
| valueUsageContext | UsageContext | ||
| valueUuid | uuid | ||
| reference | Σ C | 0..1 | string |
| type | Σ | 0..1 | uriBinding |
| identifier | Σ | 0..1 | Identifier |
| display | Σ | 0..1 | string |
| occurrence[x] | Σ | 1..1 | |
| occurrencePeriod | Period | ||
| occurrenceDateTime | S Σ | 1..1 | dateTime |
| condition | Σ C | 0..1 | Reference(Condition) |
| performer | S Σ C | 1..1 | Reference(Device) |
| reasonCode | 0..* | CodeableConcept | |
| reasonReference | C | 0..* | Reference(Condition | DiagnosticReport | DocumentReference | Observation) |
| basis | C | 0..* | Reference(Resource) |
| prediction | S C | 1..* | BackboneElement |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| outcome | 0..1 | CodeableConcept | |
| probability[x] | C | 0..1 | |
| probabilityDecimal | decimal | ||
| probabilityRange | Range | ||
| qualitativeRisk | S | 0..1 | CodeableConcept |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| coding | S Σ | 1..* | Coding |
| QualitativeRisk | S Σ | 1..1 | CodingBindingPattern |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| system | S Σ | 1..1 | uriPattern |
| version | Σ | 0..1 | string |
| code | S Σ | 1..1 | code |
| display | S Σ | 1..1 | string |
| userSelected | Σ | 0..1 | boolean |
| text | Σ | 0..1 | string |
| relativeRisk | 0..1 | decimal | |
| when[x] | 1..1 | ||
| whenRange | Range | ||
| whenPeriod | S | 1..1 | Period |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| start | S Σ C | 1..1 | dateTime |
| end | S Σ C | 0..1 | dateTime |
| rationale | S | 0..1 | string |
| mitigation | 0..1 | string | |
| note | 0..* | Annotation |
Constraints/Invarianten
| Name | Schweregrad | Beschreibung | Ausdruck |
|---|---|---|---|
| MaiaTrbeCodeOrText | error | A code from MaiaPresumedDiagnosisAssessmentType and a free-text display (code.text) must not be used at the same time. | coding.where(system = 'https://tiplu.de/fhir/maia/CodeSystem/MaiaPresumedDiagnosisAssessmentType').exists() xor text.exists() |
Terminology-Bindings
| Element | Staerke | ValueSet |
|---|---|---|
| RiskAssessment.method.coding:AssessmentMethod | required | https://tiplu.de/fhir/maia/ValueSet/MaiaAssessmentMethodVS |
| RiskAssessment.code.coding:AssessmentType | required | https://tiplu.de/fhir/maia/ValueSet/MaiaPresumedDiagnosisAssessmentTypeVS |
| RiskAssessment.prediction.qualitativeRisk.coding:QualitativeRisk | required | http://hl7.org/fhir/ValueSet/risk-probability |
Notes on Must-Support fields
| Feldname | Kurzbeschreibung | Hinweise |
|---|---|---|
| RiskAssessment.text | human-readable narrative | HTML representation of this rule-based evaluation |
| RiskAssessment.status | Status of the rule-based evaluation | Status 'preliminary' is default set for rule-based evaluation. |
| RiskAssessment.method.coding:AssessmentMethod | Assessment method used for this RiskAssessment | |
| RiskAssessment.code.coding:AssessmentType | Coding of the Tiplu presumed diagnosis | |
| RiskAssessment.code.text | Name of the custom presumed diagnosis | |
| RiskAssessment.subject.identifier | Patient ID of the referenced patient | The MAIA FHIR endpoints don't have the possibility to get the patient resource. For this, the resource identifier is mandatory. |
| RiskAssessment.encounter.extension:AccountIdentifier | Account Identifier (German: Fallnummer/Abrechnungsnummer) of the referenced account | The MAIA FHIR endpoints don't have the possibility to get the account or encounter resource. For this, the resource identifier is mandatory. |
| RiskAssessment.occurrence[x]:occurrenceDateTime | Last calculation of MAIA | |
| RiskAssessment.prediction.rationale | Reasoning | Provides the patient-specific relevant data points for the result provided by the rule-based evaluation from the patient record if possible. |