ClinicalImpression

This resource represents a health plan archetype.

Resource Structure

profile-ClinicalImpression-put-archetype (ClinicalImpression)
C
profile-ClinicalImpression-base
There are no (further) constraints on this element
Element id
ClinicalImpression
Short description
A clinical assessment performed when planning treatments and management strategies for a patient
Definition
A record of a clinical assessment performed to determine what problem(s) may affect the patient and before planning the treatments or management strategies that are best to manage a patient's condition. Assessments are often 1:1 with a clinical consultation / encounter,  but this varies greatly depending on the clinical workflow. This resource is called "ClinicalImpression" rather than "ClinicalAssessment" to avoid confusion with the recording of assessment tools such as Apgar score.
Data type
profile-ClinicalImpression-base
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.exists() and ('#'+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(uri) = '#').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
workflow: Event
v2: Partial mapping for problem evaluation
w5: clinical.general
id
Σ
0..1
id
There are no (further) constraints on this element
Element id
ClinicalImpression.id
Short description
n/a
Definition
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Comments
Sample value: "1F2436A695F84E03997490A85F5E1E73"
Data type
id
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
meta
Σ
0..1
Meta
There are no (further) constraints on this element
Element id
ClinicalImpression.meta
Short description
n/a
Definition
The 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.
Data type
Meta
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
rim: N/A
id
0..0
id
There are no (further) constraints on this element
Element id
ClinicalImpression.meta.id
Short description
Unique id for inter-element referencing
Definition
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type
id
Mappings
rim: n/a
extension
C
0..0
Extension
There are no (further) constraints on this element
Element id
ClinicalImpression.meta.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May 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.
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.
Data type
Extension
Slicing
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) url
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings
rim: n/a
rim: N/A
versionId
Σ
1..1
id
There are no (further) constraints on this element
Element id
ClinicalImpression.meta.versionId
Short description
Version specific identifier
Definition
The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.
Comments
Sample value: "1"
Data type
id
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
lastUpdated
Σ
1..1
instant
There are no (further) constraints on this element
Element id
ClinicalImpression.meta.lastUpdated
Short description
When the resource version last changed
Definition
n/a
Comments
Sample value: "2022-12-29T10:59:45.003+08:00"
Data type
instant
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
source
Σ
0..0
uri
There are no (further) constraints on this element
Element id
ClinicalImpression.meta.source
Short description
Identifies where the resource comes from
Definition
A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.
Comments
In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.
This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
Data type
uri
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
profile
Σ
1..1
canonical(StructureDefinition)
There are no (further) constraints on this element
Element id
ClinicalImpression.meta.profile
Short description
Profiles this resource claims to conform to
Definition
n/a
Comments
Sample value: "http://ihis.sg/StructureDefinition/ClinicalImpression-pophealth"
Data type
canonical(StructureDefinition)
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
security
Σ
0..0
CodingBinding
There are no (further) constraints on this element
Element id
ClinicalImpression.meta.security
Short description
Security Labels applied to this resource
Definition
Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
Comments
The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.
Data type
Coding
Binding
All Security Labels (extensible)
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
tag
Σ
0..1
Coding
There are no (further) constraints on this element
Element id
ClinicalImpression.meta.tag
Short description
Tags applied to this resource
Definition
n/a
Comments
n/a
Data type
Coding
Binding
CommonTags (example)
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
id
0..0
id
There are no (further) constraints on this element
Element id
ClinicalImpression.meta.tag.id
Short description
Unique id for inter-element referencing
Definition
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type
id
Mappings
rim: n/a
extension
C
0..0
Extension
There are no (further) constraints on this element
Element id
ClinicalImpression.meta.tag.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May 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.
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.
Data type
Extension
Slicing
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) url
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings
rim: n/a
rim: N/A
system
Σ
0..1
uri
There are no (further) constraints on this element
Element id
ClinicalImpression.meta.tag.system
Short description
Identity of the terminology system
Definition
Identity of the terminology system
Requirements
n/a
Comments
Sample value: "http://ihis.sg/coding/correlationid"
Data type
uri
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version
Σ
0..0
string
There are no (further) constraints on this element
Element id
ClinicalImpression.meta.tag.version
Short description
Version of the system - if relevant
Definition
The 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.
Comments
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.
Data type
string
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code
Σ
0..1
code
There are no (further) constraints on this element
Element id
ClinicalImpression.meta.tag.code
Short description
Symbol in syntax defined by the system
Definition
n/a
Requirements
n/a
Comments
n/a
Data type
code
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display
Σ
0..0
string
There are no (further) constraints on this element
Element id
ClinicalImpression.meta.tag.display
Short description
Representation defined by the system
Definition
A representation of the meaning of the code in the system, following the rules of the system.
Requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.
Comments
Note that FHIR strings SHALL NOT exceed 1MB in size
Data type
string
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected
Σ
0..0
boolean
There are no (further) constraints on this element
Element id
ClinicalImpression.meta.tag.userSelected
Short description
If this coding was chosen directly by the user
Definition
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Requirements
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.
Comments
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.
Data type
boolean
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source "true";     fhir:target dt:CDCoding.codingRationale\#O   ]
implicitRules
Σ ?!
0..0
uri
There are no (further) constraints on this element
Element id
ClinicalImpression.implicitRules
Short description
A set of rules under which this content was created
Definition
A 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.
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. 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.
Data type
uri
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
language
0..0
codeBinding
There are no (further) constraints on this element
Element id
ClinicalImpression.language
Short description
Language of the resource content
Definition
The base language in which the resource is written.
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).
Data type
code
Binding
IETF language tag
CommonLanguages (preferred)
Binding extensions
maxValueSet
AllLanguages
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
text
0..0
Narrative
There are no (further) constraints on this element
Element id
ClinicalImpression.text
Short description
Text summary of the resource, for human interpretation
Alternate names
narrative, html, xhtml, display
Definition
A 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.
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 information is added later.
Data type
Narrative
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
rim: N/A
rim: Act.text?
contained
C
0..0
Resource
There are no (further) constraints on this element
Element id
ClinicalImpression.contained
Short description
Contained, inline Resources
Alternate names
inline resources, anonymous resources, contained resources
Definition
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Comments
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Data type
Resource
Constraints
dom-r4b: Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems
($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)
Mappings
rim: Entity. Role, or Act
rim: N/A
extension
C
0..1
Extension
There are no (further) constraints on this element
Element id
ClinicalImpression.extension
Short description
n/a
Alternate names
extensions, user content
Definition
Additional data element required by Healthier SG
Comments
The extension is in the format of key/value pair, where the key is specified in 'url' attribute, and the value is specified in the 'value[Type]' attribute, the type can be Coding, String, Date or others depending on the definition specified in Data Type column W
All the extension url is be prefixed with "http://ihis.sg/extension" and followed by friendly short name
Data type
Extension
Slicing
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) url
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings
rim: n/a
rim: N/A
extensionArchetypeAssessorOrganization
C
0..1
Extension(Reference)
There are no (further) constraints on this element
Element id
ClinicalImpression.extension:extensionArchetypeAssessorOrganization
Short description
n/a
Alternate names
extensions, user content
Definition
Extension field for archetype provided by, optional for consumer app, mandatory for provider app
Requirements
n/a
Comments
Fixed Value: "http://ihis.sg/extension/assessor-organization"
Data type
Extension(Reference)
Extension URL
http://ihis.sg/extension/assessor-organization
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings
rim: n/a
rim: N/A
id
0..0
id
There are no (further) constraints on this element
Element id
ClinicalImpression.extension:extensionArchetypeAssessorOrganization.id
Short description
n/a
Definition
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type
id
Mappings
rim: n/a
extension
C
0..0
Extension
There are no (further) constraints on this element
Element id
ClinicalImpression.extension:extensionArchetypeAssessorOrganization.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May 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.
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.
Data type
Extension
Slicing
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) url
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings
rim: n/a
rim: N/A
url
1..1
uriFixed Value
There are no (further) constraints on this element
Element id
ClinicalImpression.extension:extensionArchetypeAssessorOrganization.url
Short description
identifies the meaning of the extension
Definition
Additional data element required by Healthier SG
Requirements
n/a
Comments
The extension is in the format of key/value pair, where the key is specified in 'url' attribute, and the value is specified in the 'value[Type]' attribute, the type can be Coding, String, Date or others depending on the definition specified in Data Type column W
All the extension url is be prefixed with "http://ihis.sg/extension" and followed by friendly short name
Data type
uri
Fixed value
http://ihis.sg/extension/assessor-organization
Mappings
rim: N/A
value[x]
1..1
There are no (further) constraints on this element
Element id
ClinicalImpression.extension:extensionArchetypeAssessorOrganization.value[x]
Short description
n/a
Definition
Grouping of value reference
Requirements
n/a
Comments
n/a
Slicing
Unordered, Open, by $this(Type)
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
rim: N/A
valueReference
1..1
Reference
There are no (further) constraints on this element
Element id
ClinicalImpression.extension:extensionArchetypeAssessorOrganization.value[x]:valueReference
Short description
n/a
Definition
Grouping of value reference
Requirements
n/a
Comments
n/a
Data type
Reference
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
rim: N/A
id
0..0
id
There are no (further) constraints on this element
Element id
ClinicalImpression.extension:extensionArchetypeAssessorOrganization.value[x]:valueReference.id
Short description
Unique id for inter-element referencing
Definition
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type
id
Mappings
rim: n/a
extension
C
0..0
Extension
There are no (further) constraints on this element
Element id
ClinicalImpression.extension:extensionArchetypeAssessorOrganization.value[x]:valueReference.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May 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.
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.
Data type
Extension
Slicing
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) url
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings
rim: n/a
rim: N/A
reference
Σ C
0..0
string
There are no (further) constraints on this element
Element id
ClinicalImpression.extension:extensionArchetypeAssessorOrganization.value[x]:valueReference.reference
Short description
n/a
Definition
n/a
Comments
Sample value: "https://pophealth.healthdxp.com/Organization/01351534ADB84794AC3A30F51A61FC77"
Data type
string
Conditions
The cardinality or value of this element may be affected by these constraints: ele-1, ref-1
Constraints
ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
rim: N/A
type
Σ
1..1
uriBindingFixed Value
There are no (further) constraints on this element
Element id
ClinicalImpression.extension:extensionArchetypeAssessorOrganization.value[x]:valueReference.type
Short description
n/a
Definition
Indicate that the the identifier below is for Organization
Requirements
n/a
Comments
Fixed Value : "Organization"
Data type
uri
Binding
ResourceType (extensible)
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Fixed value
Organization
Mappings
rim: n/a
rim: N/A
identifier
Σ
1..1
Identifier
There are no (further) constraints on this element
Element id
ClinicalImpression.extension:extensionArchetypeAssessorOrganization.value[x]:valueReference.identifier
Short description
n/a
Definition
Grouping of identifier
Requirements
n/a
Comments
n/a
Data type
Identifier
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
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
rim: .identifier
id
0..0
id
There are no (further) constraints on this element
Element id
ClinicalImpression.extension:extensionArchetypeAssessorOrganization.value[x]:valueReference.identifier.id
Short description
Unique id for inter-element referencing
Definition
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type
id
Mappings
rim: n/a
extension
C
0..0
Extension
There are no (further) constraints on this element
Element id
ClinicalImpression.extension:extensionArchetypeAssessorOrganization.value[x]:valueReference.identifier.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May 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.
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.
Data type
Extension
Slicing
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) url
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings
rim: n/a
rim: N/A
use
Σ ?!
0..0
codeBinding
There are no (further) constraints on this element
Element id
ClinicalImpression.extension:extensionArchetypeAssessorOrganization.value[x]:valueReference.identifier.use
Short description
usual | official | temp | secondary | old (If known)
Definition
The purpose of this identifier.
Requirements
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Comments
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Data type
code
Binding
IdentifierUse (required)
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: N/A
rim: Role.code or implied by context
type
Σ
0..0
CodeableConceptBinding
There are no (further) constraints on this element
Element id
ClinicalImpression.extension:extensionArchetypeAssessorOrganization.value[x]:valueReference.identifier.type
Short description
Description of identifier
Definition
A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
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.
Data type
CodeableConcept
Binding
Identifier Type Codes (extensible)
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
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
system
Σ
1..1
uriFixed Value
There are no (further) constraints on this element
Element id
ClinicalImpression.extension:extensionArchetypeAssessorOrganization.value[x]:valueReference.identifier.system
Short description
n/a
Definition
The namespace for the identifier hci code
Requirements
n/a
Comments
Fixed Value : "http://ihis.sg/identifier/hci-code"
Data type
uri
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Fixed value
http://ihis.sg/identifier/hci-code
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
value
Σ C
1..1
string
There are no (further) constraints on this element
Element id
ClinicalImpression.extension:extensionArchetypeAssessorOrganization.value[x]:valueReference.identifier.value
Short description
n/a
Definition
Value of hci code
Requirements
n/a
Comments
Sample Value : "HCI1234D"
Data type
string
Conditions
The cardinality or value of this element may be affected by these constraints: ele-1, empty-value-validation
Constraints
ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
empty-value-validation: Organization identifier value should not be empty
$this.length() > 0
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
period
Σ C
0..0
Period
There are no (further) constraints on this element
Element id
ClinicalImpression.extension:extensionArchetypeAssessorOrganization.value[x]:valueReference.identifier.period
Short description
Time period when id is/was valid for use
Definition
Time period during which identifier is/was valid for use.
Comments
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").
Period is not used for a duration (a measure of elapsed time). See Duration.
Data type
Period
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() 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
assigner
Σ C
0..0
Reference(Organization)
There are no (further) constraints on this element
Element id
ClinicalImpression.extension:extensionArchetypeAssessorOrganization.value[x]:valueReference.identifier.assigner
Short description
Organization that issued id (may be just text)
Definition
Organization that issued/manages the identifier.
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.
Data type
Reference(Organization)
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
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
display
Σ
0..0
string
There are no (further) constraints on this element
Element id
ClinicalImpression.extension:extensionArchetypeAssessorOrganization.value[x]:valueReference.display
Short description
Text alternative for the resource
Definition
Plain text narrative that identifies the resource in addition to the resource reference.
Comments
This is generally not the same as the Resource.text of the referenced resource.  The purpose is to identify what's being referenced, not to fully describe it.
Data type
string
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
rim: N/A
modifierExtension
?! C
0..*
Extension
There are no (further) constraints on this element
Element id
ClinicalImpression.modifierExtension
Short description
Extensions that cannot be ignored
Alternate names
extensions, user content
Definition
May 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).
Requirements
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.
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.
Data type
Extension
Slicing
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) url
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings
rim: n/a
rim: N/A
identifier
Σ
0..0
Identifier
There are no (further) constraints on this element
Element id
ClinicalImpression.identifier
Short description
Business identifier
Definition
Business identifiers assigned to this clinical impression by the performer or other systems which remain constant as the resource is updated and propagates from server to server.
Requirements
Allows identification of the clinical impression as it is known by various participating systems and in a way that remains consistent across servers.
Comments
This is a business identifier, not a resource identifier (see discussion).  It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types.  For example, multiple Patient and a Person resource instance might share the same social insurance number.
Data type
Identifier
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
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
workflow: Event.identifier
w5: FiveWs.identifier
v2: PID-3
status
Σ ?!
1..1
codeBindingFixed Value
There are no (further) constraints on this element
Element id
ClinicalImpression.status
Short description
n/a
Definition
Fixed to completed
Requirements
n/a
Comments
Fixed Value: "completed"
Data type
code
Binding
The workflow state of a clinical impression.
ClinicalImpressionStatus (required)
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Fixed value
completed
Mappings
rim: n/a
workflow: Event.status
w5: FiveWs.status
v2: PRB-14
statusReason
0..0
CodeableConcept
There are no (further) constraints on this element
Element id
ClinicalImpression.statusReason
Short description
Reason for current status
Alternate names
Suspended Reason, Cancelled Reason
Definition
Captures the reason for the current state of the ClinicalImpression.
Comments
This is generally only used for "exception" statuses such as "not-done", "suspended" or "cancelled".
[distinct reason codes for different statuses can be enforced using invariants if they are universal bindings].
Data type
CodeableConcept
Binding
Codes identifying the reason for the current state of a clinical impression.
(unbound) (example)
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.statusReason
rim: .inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
code
Σ
1..1
CodeableConceptBinding
There are no (further) constraints on this element
Element id
ClinicalImpression.code
Short description
n/a
Alternate names
type
Definition
FHIR Value set "ClinicalImpression Code"
Requirements
n/a
Comments
n/a
Data type
CodeableConcept
Binding
Identifies categories of clinical impressions.  This is a place-holder only.  It may be removed.
hsg-clinical-impression-code (required)
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.code
w5: FiveWs.what[x]
id
0..0
id
There are no (further) constraints on this element
Element id
ClinicalImpression.code.id
Short description
Unique id for inter-element referencing
Definition
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type
id
Mappings
rim: n/a
extension
C
0..0
Extension
There are no (further) constraints on this element
Element id
ClinicalImpression.code.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May 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.
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.
Data type
Extension
Slicing
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) url
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings
rim: n/a
rim: N/A
coding
Σ
1..*
Coding
There are no (further) constraints on this element
Element id
ClinicalImpression.code.coding
Short description
n/a
Definition
Grouping of coding
Requirements
n/a
Comments
n/a
Data type
Coding
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id
0..0
id
There are no (further) constraints on this element
Element id
ClinicalImpression.code.coding.id
Short description
Unique id for inter-element referencing
Definition
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type
id
Mappings
rim: n/a
extension
C
0..0
Extension
There are no (further) constraints on this element
Element id
ClinicalImpression.code.coding.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May 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.
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.
Data type
Extension
Slicing
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) url
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings
rim: n/a
rim: N/A
system
Σ
1..1
uriFixed Value
There are no (further) constraints on this element
Element id
ClinicalImpression.code.coding.system
Short description
n/a
Definition
Identity of the terminology system
Requirements
n/a
Comments
Fixed Value: "http://ihis.sg/ValueSet/hsg-clinical-impression-code"
Data type
uri
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Fixed value
http://ihis.sg/ValueSet/hsg-clinical-impression-code
Mappings
rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version
Σ
0..0
string
There are no (further) constraints on this element
Element id
ClinicalImpression.code.coding.version
Short description
Version of the system - if relevant
Definition
The 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.
Comments
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.
Data type
string
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code
Σ
1..1
code
There are no (further) constraints on this element
Element id
ClinicalImpression.code.coding.code
Short description
n/a
Definition
Internal code for the terminology code
Requirements
n/a
Comments
Fixed Value: "archetype"
Data type
code
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display
Σ
0..1
string
There are no (further) constraints on this element
Element id
ClinicalImpression.code.coding.display
Short description
n/a
Definition
Description of the terminology code for display purpose
Requirements
n/a
Comments
Fixed value: "Archetype"
Data type
string
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected
Σ
0..0
boolean
There are no (further) constraints on this element
Element id
ClinicalImpression.code.coding.userSelected
Short description
If this coding was chosen directly by the user
Definition
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Requirements
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.
Comments
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.
Data type
boolean
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source "true";     fhir:target dt:CDCoding.codingRationale\#O   ]
text
Σ
0..0
string
There are no (further) constraints on this element
Element id
ClinicalImpression.code.text
Short description
Plain text representation of the concept
Definition
A 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.
Requirements
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.
Comments
Very often the text is the same as a displayName of one of the codings.
Data type
string
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
description
Σ
0..0
string
There are no (further) constraints on this element
Element id
ClinicalImpression.description
Short description
Why/how the assessment was performed
Definition
A summary of the context and/or cause of the assessment - why / where it was performed, and what patient events/status prompted it.
Comments
Note that FHIR strings SHALL NOT exceed 1MB in size
Data type
string
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
subject
Σ C
1..1
Reference(Group | Patient)
There are no (further) constraints on this element
Element id
ClinicalImpression.subject
Short description
n/a
Definition
Reference to the patient in patient master to link this healthplan
Requirements
n/a
Comments
n/a
Data type
Reference(Group | Patient)
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.subject
w5: FiveWs.subject[x]
v2: PID-3
w5: FiveWs.subject
id
0..0
id
There are no (further) constraints on this element
Element id
ClinicalImpression.subject.id
Short description
Unique id for inter-element referencing
Definition
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type
id
Mappings
rim: n/a
extension
C
0..0
Extension
There are no (further) constraints on this element
Element id
ClinicalImpression.subject.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May 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.
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.
Data type
Extension
Slicing
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) url
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings
rim: n/a
rim: N/A
reference
Σ C
0..0
string
There are no (further) constraints on this element
Element id
ClinicalImpression.subject.reference
Short description
n/a
Definition
The logical reference value of subject
Requirements
n/a
Comments
Sample Value: "https://pophealth.healthdxp.com/Patient/F9B427EB826B410C9B1C4B8F8D65A300"
Data type
string
Conditions
The cardinality or value of this element may be affected by these constraints: ele-1, ref-1
Constraints
ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
rim: N/A
type
Σ
1..1
uriBindingFixed Value
There are no (further) constraints on this element
Element id
ClinicalImpression.subject.type
Short description
n/a
Definition
Indicate that the identifier below is for Patient
Requirements
n/a
Comments
Fixed Value: "Patient"
Data type
uri
Binding
ResourceType (extensible)
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Fixed value
Patient
Mappings
rim: n/a
rim: N/A
identifier
Σ
1..1
Identifier
There are no (further) constraints on this element
Element id
ClinicalImpression.subject.identifier
Short description
n/a
Definition
Grouping of identifier
Requirements
n/a
Comments
n/a
Data type
Identifier
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
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
rim: .identifier
id
0..0
id
There are no (further) constraints on this element
Element id
ClinicalImpression.subject.identifier.id
Short description
Unique id for inter-element referencing
Definition
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type
id
Mappings
rim: n/a
extension
C
0..0
Extension
There are no (further) constraints on this element
Element id
ClinicalImpression.subject.identifier.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May 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.
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.
Data type
Extension
Slicing
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) url
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings
rim: n/a
rim: N/A
use
Σ ?!
0..0
codeBinding
There are no (further) constraints on this element
Element id
ClinicalImpression.subject.identifier.use
Short description
usual | official | temp | secondary | old (If known)
Definition
The purpose of this identifier.
Requirements
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Comments
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Data type
code
Binding
IdentifierUse (required)
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: N/A
rim: Role.code or implied by context
type
Σ
0..0
CodeableConceptBinding
There are no (further) constraints on this element
Element id
ClinicalImpression.subject.identifier.type
Short description
Description of identifier
Definition
A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
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.
Data type
CodeableConcept
Binding
Identifier Type Codes (extensible)
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
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
system
Σ
1..1
uriFixed Value
There are no (further) constraints on this element
Element id
ClinicalImpression.subject.identifier.system
Short description
n/a
Definition
The namespace for the identifier patient nric
Requirements
n/a
Comments
Fixed Value: "http://ihis.sg/identifier/nric"
Data type
uri
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Fixed value
http://ihis.sg/identifier/nric
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
value
Σ C
1..1
string
There are no (further) constraints on this element
Element id
ClinicalImpression.subject.identifier.value
Short description
n/a
Definition
Value of patient nric
Requirements
n/a
Comments
n/a
Data type
string
Conditions
The cardinality or value of this element may be affected by these constraints: ele-1, empty-value-validation
Constraints
ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
empty-value-validation: Patient identifier value should not be empty
$this.length() > 0
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
period
Σ C
0..0
Period
There are no (further) constraints on this element
Element id
ClinicalImpression.subject.identifier.period
Short description
Time period when id is/was valid for use
Definition
Time period during which identifier is/was valid for use.
Comments
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").
Period is not used for a duration (a measure of elapsed time). See Duration.
Data type
Period
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() 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
assigner
Σ C
0..0
Reference(Organization)
There are no (further) constraints on this element
Element id
ClinicalImpression.subject.identifier.assigner
Short description
Organization that issued id (may be just text)
Definition
Organization that issued/manages the identifier.
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.
Data type
Reference(Organization)
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
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
display
Σ
0..0
string
There are no (further) constraints on this element
Element id
ClinicalImpression.subject.display
Short description
Text alternative for the resource
Definition
Plain text narrative that identifies the resource in addition to the resource reference.
Comments
This is generally not the same as the Resource.text of the referenced resource.  The purpose is to identify what's being referenced, not to fully describe it.
Data type
string
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
rim: N/A
encounter
Σ C
0..0
Reference(Encounter)
There are no (further) constraints on this element
Element id
ClinicalImpression.encounter
Short description
Encounter created as part of
Definition
The Encounter during which this ClinicalImpression was created or to which the creation of this record is tightly associated.
Comments
This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.
Data type
Reference(Encounter)
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.context
w5: FiveWs.context
effective[x]
Σ
0..0
There are no (further) constraints on this element
Element id
ClinicalImpression.effective[x]
Short description
Time of assessment
Definition
The point in time or period over which the subject was assessed.
Comments
This SHOULD be accurate to at least the minute, though some assessments only have a known date.
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
workflow: Event.occurrence[x]
w5: FiveWs.done[x]
v2: PRB-2
date
Σ C
1..1
dateTime
There are no (further) constraints on this element
Element id
ClinicalImpression.date
Short description
n/a
Definition
Archetype submission datetime
Requirements
n/a
Comments
Sample Value: "2022-06-01T23:59:59+08:00", "2023-05-03T18:18:38.358+08:00"
Data type
dateTime
Conditions
The cardinality or value of this element may be affected by these constraints: ele-1, submission-date-validation
Constraints
ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
submission-date-validation: The submission date of archetype should not be later than the current date
$this.convertsToDate() = false or $this.toDate() <= today()
Mappings
rim: n/a
w5: FiveWs.recorded
assessor
Σ C
0..0
Reference(Practitioner | PractitionerRole)
There are no (further) constraints on this element
Element id
ClinicalImpression.assessor
Short description
The clinician performing the assessment
Definition
The clinician performing the assessment.
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.
Data type
Reference(Practitioner | PractitionerRole)
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.performer.actor
w5: FiveWs.author
v2: ROL-4
previous
C
0..0
Reference(ClinicalImpression)
There are no (further) constraints on this element
Element id
ClinicalImpression.previous
Short description
Reference to last assessment
Definition
A reference to the last assessment that was conducted on this patient. Assessments are often/usually ongoing in nature; a care provider (practitioner or team) will make new assessments on an ongoing basis as new data arises or the patient's conditions changes.
Comments
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).
Data type
Reference(ClinicalImpression)
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
problem
Σ C
0..0
Reference(AllergyIntolerance | Condition)
There are no (further) constraints on this element
Element id
ClinicalImpression.problem
Short description
Relevant impressions of patient state
Definition
A list of the relevant problems/conditions for a patient.
Comments
e.g. The patient is a pregnant, has congestive heart failure, has an ‎Adenocarcinoma, and is allergic to penicillin.
Data type
Reference(AllergyIntolerance | Condition)
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
w5: FiveWs.why[x]
v2: PRB-3 / IAM-7
investigation
0..0
BackboneElement
There are no (further) constraints on this element
Element id
ClinicalImpression.investigation
Short description
One or more sets of investigations (signs, symptoms, etc.)
Definition
One or more sets of investigations (signs, symptoms, etc.). The actual grouping of investigations varies greatly depending on the type and context of the assessment. These investigations may include data generated during the assessment process, or data previously generated and recorded that is pertinent to the outcomes.
Data type
BackboneElement
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
protocol
0..0
uri
There are no (further) constraints on this element
Element id
ClinicalImpression.protocol
Short description
Clinical Protocol followed
Definition
Reference to a specific published clinical protocol that was followed during this assessment, and/or that provides evidence in support of the diagnosis.
Comments
see http://en.wikipedia.org/wiki/Uniform_resource_identifier
Data type
uri
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
summary
0..0
string
There are no (further) constraints on this element
Element id
ClinicalImpression.summary
Short description
Summary of the assessment
Definition
A text summary of the investigations and the diagnosis.
Comments
Note that FHIR strings SHALL NOT exceed 1MB in size
Data type
string
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: OBX
finding
1..*
BackboneElement
There are no (further) constraints on this element
Element id
ClinicalImpression.finding
Short description
n/a
Definition
Archetype value
Requirements
n/a
Comments
n/a
Data type
BackboneElement
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
id
0..0
id
There are no (further) constraints on this element
Element id
ClinicalImpression.finding.id
Short description
Unique id for inter-element referencing
Definition
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type
id
Mappings
rim: n/a
extension
C
0..0
Extension
There are no (further) constraints on this element
Element id
ClinicalImpression.finding.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May 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.
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.
Data type
Extension
Slicing
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) url
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings
rim: n/a
rim: N/A
modifierExtension
Σ ?! C
0..0
Extension
There are no (further) constraints on this element
Element id
ClinicalImpression.finding.modifierExtension
Short description
Extensions that cannot be ignored even if unrecognized
Alternate names
extensions, user content, modifiers
Definition
May 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).
Requirements
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.
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.
Data type
Extension
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings
rim: n/a
rim: N/A
itemCodeableConcept
1..1
CodeableConceptBinding
There are no (further) constraints on this element
Element id
ClinicalImpression.finding.itemCodeableConcept
Short description
n/a
Definition
Grouping of item
Requirements
n/a
Comments
n/a
Data type
CodeableConcept
Binding
Identification of the Condition or diagnosis.
hsg-archetype (required)
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: OBX
id
0..0
id
There are no (further) constraints on this element
Element id
ClinicalImpression.finding.itemCodeableConcept.id
Short description
Unique id for inter-element referencing
Definition
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type
id
Mappings
rim: n/a
extension
C
0..0
Extension
There are no (further) constraints on this element
Element id
ClinicalImpression.finding.itemCodeableConcept.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May 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.
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.
Data type
Extension
Slicing
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) url
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings
rim: n/a
rim: N/A
coding
Σ
1..*
Coding
There are no (further) constraints on this element
Element id
ClinicalImpression.finding.itemCodeableConcept.coding
Short description
n/a
Definition
Grouping of item's coding
Requirements
n/a
Comments
n/a
Data type
Coding
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id
0..0
id
There are no (further) constraints on this element
Element id
ClinicalImpression.finding.itemCodeableConcept.coding.id
Short description
Unique id for inter-element referencing
Definition
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type
id
Mappings
rim: n/a
extension
C
0..0
Extension
There are no (further) constraints on this element
Element id
ClinicalImpression.finding.itemCodeableConcept.coding.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May 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.
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.
Data type
Extension
Slicing
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) url
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings
rim: n/a
rim: N/A
system
Σ
1..1
uriFixed Value
There are no (further) constraints on this element
Element id
ClinicalImpression.finding.itemCodeableConcept.coding.system
Short description
n/a
Definition
Identity of the terminology system
Requirements
n/a
Comments
Fixed Value: "http://ihis.sg/ValueSet/hsg-archetype"
Data type
uri
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Fixed value
http://ihis.sg/ValueSet/hsg-archetype
Mappings
rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version
Σ
0..0
string
There are no (further) constraints on this element
Element id
ClinicalImpression.finding.itemCodeableConcept.coding.version
Short description
Version of the system - if relevant
Definition
The 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.
Comments
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.
Data type
string
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code
Σ
1..1
code
There are no (further) constraints on this element
Element id
ClinicalImpression.finding.itemCodeableConcept.coding.code
Short description
n/a
Definition
Internal code for the terminology code
Requirements
n/a
Comments
Sample Value: "a1"
Data type
code
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display
Σ
0..1
string
There are no (further) constraints on this element
Element id
ClinicalImpression.finding.itemCodeableConcept.coding.display
Short description
n/a
Definition
Description of the terminology code for display purpose
Requirements
n/a
Comments
Sample value: "Well"
Data type
string
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected
Σ
0..0
boolean
There are no (further) constraints on this element
Element id
ClinicalImpression.finding.itemCodeableConcept.coding.userSelected
Short description
If this coding was chosen directly by the user
Definition
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Requirements
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.
Comments
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.
Data type
boolean
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source "true";     fhir:target dt:CDCoding.codingRationale\#O   ]
text
Σ
0..0
string
There are no (further) constraints on this element
Element id
ClinicalImpression.finding.itemCodeableConcept.text
Short description
Plain text representation of the concept
Definition
A 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.
Requirements
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.
Comments
Very often the text is the same as a displayName of one of the codings.
Data type
string
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
itemReference
C
0..0
Reference(Condition | Media | Observation)
There are no (further) constraints on this element
Element id
ClinicalImpression.finding.itemReference
Short description
What was found
Definition
Specific reference for finding or diagnosis, which may include ruled-out or resolved conditions.
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.
Data type
Reference(Condition | Media | Observation)
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: OBX
basis
0..0
string
There are no (further) constraints on this element
Element id
ClinicalImpression.finding.basis
Short description
Which investigations support finding
Definition
Which investigations support finding or diagnosis.
Comments
Note that FHIR strings SHALL NOT exceed 1MB in size
Data type
string
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
prognosisCodeableConcept
0..0
CodeableConcept
There are no (further) constraints on this element
Element id
ClinicalImpression.prognosisCodeableConcept
Short description
Estimate of likely outcome
Definition
Estimate of likely outcome.
Comments
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.
Data type
CodeableConcept
Binding
Prognosis or outlook findings.
ClinicalImpressionPrognosis (example)
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: PRB-22
prognosisReference
C
0..0
Reference(RiskAssessment)
There are no (further) constraints on this element
Element id
ClinicalImpression.prognosisReference
Short description
RiskAssessment expressing likely outcome
Definition
RiskAssessment expressing likely outcome.
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.
Data type
Reference(RiskAssessment)
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
supportingInfo
C
0..0
Reference(Resource)
There are no (further) constraints on this element
Element id
ClinicalImpression.supportingInfo
Short description
Information supporting the clinical impression
Definition
Information supporting the clinical impression.
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.
Data type
Reference(Resource)
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
note
0..0
Annotation
There are no (further) constraints on this element
Element id
ClinicalImpression.note
Short description
Comments made about the ClinicalImpression
Definition
Commentary about the impression, typically recorded after the impression itself was made, though supplemental notes by the original author could also appear.
Comments
Don't use this element for content that should more properly appear as one of the specific elements of the impression.
Data type
Annotation
Conditions
The 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 unless an empty Parameters resource
hasValue() or (children().count() > id.count()) or $this is Parameters
Mappings
rim: n/a
v2: N/A
rim: Act
workflow: Event.note

Terminology Bindings

Constraints