Procesos

Egresos Hospitalarios

Aquí se presentan todos los recursos que se utilizaron para mapear la información de los egresos hospitalarios.

  1. Definición de estructura para los datos de los egresos hospitalarios, aqui se definen principalmente los campos utilizados del recurso Encounter de HL7 FHIR. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/encounteregresoshospv3.

status
subjectReference(Patient_apimin_v3)
end
length
conditionReference(Condition_egresosHosp_apimin_v3)
locationReference(Location_apimin_v3)

  1. Definición de estructura para los datos del paciente. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/Patientapiminv3.

system
valueS
birthDateS

  1. Definición de estructura para los datos del establecimiento. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/organizationapimin.

system
value
name
text

  1. Definición de estructura para los datos de las condiciones crónicas. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/conditionegresoshospapiminv3.

code
display
textS

Búsquedas

Parámetros de Búsqueda Egresos Hospitalarios

Nombre Tipo Descripción Expresión Ejemplo
subject token Utilizado como el rut del paciente sin dígito verificador Encounter.subject subject.identifier=1111111
_profile token Utilizado como parametro identificador de esquema de datos por minsal y perfil FHIR _profile _profile=http://cens.cl/fhir/StructureDefinition/hospitaldigital-egresosHospitalarios
date date Fecha de egreso en formato YYYY-MM-DD Encounter.date date=ge2018-10-12
date=lt2018-10-12
date=2018-10-12
reason token Selección de tipo de egreso(intento de suicidio, condición crónica) Encounter.reason reason=condicionesCronicas
reason=intentosSuicidio

Prefijos implementados para búsquedas por fecha

Expresión Definición Ejemplo Significado
ge Mayor o Igual que ge2018-10-12 Resultados con fecha posterior o igual a 2018-10-12
lt Menor que lt2018-10-12 Resultados con fecha anterior a 2018-10-12

Referencia: Documentación completa en FHIR

Ejemplos de búsqueda

  • Búsqueda solo por rut
    GET [base]/Encounter?subject.identifier=10533196&_profile=http://cens.cl/fhir/StructureDefinition/hospitaldigital-egresosHospitalarios
    
  • Búsqueda por rut y rango de fechas
    GET [base]/Encounter?subject.identifier=10533196&_profile=http://cens.cl/fhir/StructureDefinition/hospitaldigital-egresosHospitalarios&date=ge2017-06-12&date=lt2017-06-14
    
  • Búsqueda de condiciones crónicas por rut
    GET [base]/Encounter?subject:Patient.identifier=19824900&reason=condicionesCronicas&_profile=http://cens.cl/fhir/StructureDefinition/hospitaldigital-egresosHospitalarios
    
  • Búsqueda de intentos de suicidio por rut
    GET [base]/Encounter?subject:Patient.identifier=19824900&reason=intentosSuicidio&_profile=http://cens.cl/fhir/StructureDefinition/hospitaldigital-egresosHospitalarios
    
  • Búsqueda de condiciones crónicas por rut y fecha
    GET [base]/Encounter?subject.identifier=10533196&_profile=http://cens.cl/fhir/StructureDefinition/hospitaldigital-egresosHospitalarios&date=ge2017-06-12&date=lt2017-06-14&reason=condicionesCronicas
    
  • Búsqueda de intentos de suicidio por rut y fecha
    GET [base]/Encounter?subject.identifier=10533196&_profile=http://cens.cl/fhir/StructureDefinition/hospitaldigital-egresosHospitalarios&date=ge2017-06-12&date=lt2017-06-14&reason=intentosSuicidio
    

Ejemplo de response

{
    "resourceType": "Bundle",
    "id": "c2fa3bd1-59c0-488b-bfa0-7ef82e2907c8",
    "meta": {
        "lastUpdated": "2019-01-14T23:08:04.032-03:00"
    },
    "type": "searchset",
    "total": 1,
    "link": [
        {
            "relation": "self",
            "url": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/Encounter?_profile=http%3A%2F%2Fcens.cl%2Ffhir%2FStructureDefinition%2Fhospitaldigital-egresosHospitalarios&date=ge2017-06-12&date=lt2017-06-14&subject.identifier=10533196"
        }
    ],
    "entry": [
        {
            "fullUrl": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/Encounter/339776154",
            "resource": {
                "resourceType": "Encounter",
                "id": "339776154",
                "contained": [
                    {
                        "resourceType": "Patient",
                        "id": "p1",
                        "identifier": [
                            {
                                "system": "https://www.srcei.cl/RUT",
                                "value": "10533196"
                            }
                        ]
                    },
                    {
                        "resourceType": "Condition",
                        "id": "con1",
                        "code": {
                            "text": "COLECISTITIS CRÓNICA/CÁLCULOS BILIARES"
                        }
                    },
                    {
                        "resourceType": "Condition",
                        "id": "con2",
                        "code": {
                            "coding": [
                                {
                                    "code": "K802",
                                    "display": "CALCULO DE LA VESICULA BILIAR SIN COLECISTITIS"
                                }
                            ],
                            "text": "Diagnostico Principal"
                        }
                    },
                    {
                        "resourceType": "Condition",
                        "id": "con3",
                        "code": {
                            "text": "Causa Externa"
                        }
                    },
                    {
                        "resourceType": "Location",
                        "id": "loc",
                        "identifier": [
                            {
                                "system": "http://www.deis.cl",
                                "value": "111295"
                            }
                        ],
                        "name": "Clínica Bicentenario"
                    }
                ],
                "status": "finished",
                "type": [
                    {
                        "coding": [
                            {
                                "system": "http://browser.ihtsdotools.org",
                                "code": "27624003",
                                "display": "enfermedad crónica"
                            }
                        ]
                    }
                ],
                "subject": {
                    "reference": "#p1"
                },
                "period": {
                    "start": "2017-06-12T00:00:00-04:00",
                    "end": "2017-06-13T00:00:00-04:00"
                },
                "length": {
                    "value": 1
                },
                "diagnosis": [
                    {
                        "condition": {
                            "reference": "#con1"
                        }
                    },
                    {
                        "condition": {
                            "reference": "#con2"
                        }
                    },
                    {
                        "condition": {
                            "reference": "#con3"
                        }
                    }
                ],
                "location": [
                    {
                        "location": {
                            "reference": "#loc"
                        }
                    }
                ]
            }
        }
    ]
}

Dicccionario de Datos

Diccionario de Encounter

Encounter
DefinitionAn interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient.
Cardinality0...*
AliasVisit
Invariants
  • dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-1:If the resource is contained in another resource, it SHALL NOT contain any narrative
    contained.text.empty()
  • dom-4:If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-3:If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
    contained.where(('#'+id in %resource.descendants().reference).not()).empty()
Mappings
  • rim:Entity. Role, or Act
  • rim:Encounter[@moodCode='EVN']
  • w5:workflow.encounter
Encounter.id
DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality0...1
Typeid
SummaryTrue
Comments

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

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

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

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

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

A human language.

languages (extensible)
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
Encounter.text
DefinitionA human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Cardinality0...1
TypeNarrative
Aliasnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
  • rim:Act.text?
Encounter.contained
DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Cardinality0...*
TypeResource
Aliasinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.identifier
DefinitionIdentifier(s) by which this encounter is known.
Cardinality0...*
TypeIdentifier
SummaryTrue
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim:II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd:Identifier
  • v2:PV1-19
  • rim:.id
  • w5:id
Encounter.status
DefinitionSe define el estado del encuentro.
Cardinality1...1
Typecode
Binding

Current state of the encounter

encounter-status (required)
ModifierTrue
SummaryTrue
Comments

Note that internal business rules will detemine the appropraite transitions that may occur between statuses (and also classes).

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:No clear equivalent in HL7 v2; active/finished could be inferred from PV1-44, PV1-45, PV2-24; inactive could be inferred from PV2-16
  • rim:.statusCode
  • w5:status
  • api-minsal:tipo_fuente
Encounter.statusHistory
DefinitionThe status history permits the encounter resource to contain the status history without needing to read through the historical versions of the resource, or even have the server store them.
Cardinality0...*
TypeBackboneElement
Comments

The current status is always found in the current version of the resource, not the status history.

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

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.statusHistory.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.statusHistory.status
Definitionplanned | arrived | triaged | in-progress | onleave | finished | cancelled +.
Cardinality1...1
Typecode
Binding

Current state of the encounter

encounter-status (required)
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
Encounter.statusHistory.period
DefinitionThe time that the episode was in the specified status.
Cardinality1...1
TypePeriod
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • per-1:If present, start SHALL have a lower value than end
    start.empty() or end.empty() or (start <= end)
Mappings
  • rim:n/a
  • v2:DR
  • rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
Encounter.class
Definitioninpatient | outpatient | ambulatory | emergency +.
Cardinality0...1
TypeCoding
Binding

Classification of the encounter

HL7 v3 Value Set ActEncounterCode (extensible)
SummaryTrue
Comments

Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim:CV
  • orim:fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2:PV1-2
  • rim:.inboundRelationship[typeCode=SUBJ].source[classCode=LIST].code
  • w5:class
Encounter.classHistory
DefinitionThe class history permits the tracking of the encounters transitions without needing to go through the resource history. This would be used for a case where an admission starts of as an emergency encounter, then transisions into an inpatient scenario. Doing this and not restarting a new encounter ensures that any lab/diagnostic results can more easily follow the patient and not require re-processing and not get lost or cancelled during a kindof discharge from emergency to inpatient.
Cardinality0...*
TypeBackboneElement
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
Encounter.classHistory.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.classHistory.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.classHistory.class
Definitioninpatient | outpatient | ambulatory | emergency +.
Cardinality1...1
TypeCoding
Binding

Classification of the encounter

HL7 v3 Value Set ActEncounterCode (extensible)
Comments

Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim:CV
  • orim:fhir:Coding rdfs:subClassOf dt:CDCoding
Encounter.classHistory.period
DefinitionThe time that the episode was in the specified class.
Cardinality1...1
TypePeriod
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • per-1:If present, start SHALL have a lower value than end
    start.empty() or end.empty() or (start <= end)
Mappings
  • rim:n/a
  • v2:DR
  • rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
Encounter.type
DefinitionSpecific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation).
Cardinality0...*
TypeCodeableConcept
Binding

The type of encounter

encounter-type (example)
SummaryTrue
Comments

Since there are many ways to further classify encounters, this element is 0..*.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:PV1-4 / PV1-18
  • rim:.code
  • w5:class
Encounter.priority
DefinitionIndicates the urgency of the encounter.
Cardinality0...1
TypeCodeableConcept
Binding

Indicates the urgency of the encounter.

HL7 v3 Value Set ActPriority (example)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:PV2-25
  • rim:.priorityCode
  • w5:grade
Encounter.subject
DefinitionA quien hace referencia el encuentro. Usualmente es a un paciente, pero no siempre es así.
Cardinality0...1
TypeReference(Patient_apimin_v3)
SummaryTrue
Aliaspatient
Comments

While the encounter is always about the patient, the patient may not actually be known in all contexts of use, and there may be a group of patients that could be anonymous (such as in a group therapy for Alcoholics Anonymous - where the recording of the encounter could be used for billing on the number of people/staff and not important to the context of the specific patients) or alternately in veterinary care a herd of sheep receiving treatment (where the animals are not individually tracked).

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:PID-3
  • rim:.participation[typeCode=SBJ]/role[classCode=PAT]
  • w5:who.focus
Encounter.episodeOfCare
DefinitionWhere a specific encounter should be classified as a part of a specific episode(s) of care this field should be used. This association can facilitate grouping of related encounters together for a specific purpose, such as government reporting, issue tracking, association via a common problem. The association is recorded on the encounter as these are typically created after the episode of care, and grouped on entry rather than editing the episode of care to append another encounter to it (the episode of care could span years).
Cardinality0...*
TypeReference(EpisodeOfCare)
SummaryTrue
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:PV1-54, PV1-53
  • w5:context
Encounter.incomingReferral
DefinitionThe referral request this encounter satisfies (incoming referral).
Cardinality0...*
TypeReference(ReferralRequest)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.reason.ClinicalDocument
Encounter.participant
DefinitionThe list of people responsible for providing the service.
Cardinality0...*
TypeBackboneElement
SummaryTrue
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:ROL
  • rim:.participation[typeCode=PFM]
Encounter.participant.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.participant.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.participant.type
DefinitionRole of participant in encounter.
Cardinality0...*
TypeCodeableConcept
Binding

Role of participant in encounter

encounter-participant-type (extensible)
SummaryTrue
Comments

The participant type indicates how an individual partitipates in an encounter. It includes non-practitioner participants, and for practitioners this is to describe the action type in the context of this encounter (e.g. Admitting Dr, Attending Dr, Translator, Consulting Dr). This is different to the practitioner roles which are functional roles, derived from terms of employment, education, licensing, etc.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:ROL-3 (or maybe PRT-4)
  • rim:.functionCode
Encounter.participant.period
DefinitionThe period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period.
Cardinality0...1
TypePeriod
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • per-1:If present, start SHALL have a lower value than end
    start.empty() or end.empty() or (start <= end)
Mappings
  • rim:n/a
  • v2:DR
  • rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2:ROL-5, ROL-6 (or maybe PRT-5)
  • rim:.time
Encounter.participant.individual
DefinitionPersons involved in the encounter other than the patient.
Cardinality0...1
TypeReference(Practitioner | RelatedPerson)
SummaryTrue
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:ROL-4
  • rim:.role
  • w5:who
Encounter.appointment
DefinitionThe appointment that scheduled this encounter.
Cardinality0...1
TypeReference(Appointment)
SummaryTrue
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:SCH-1 / SCH-2
  • rim:.outboundRelationship[typeCode=FLFS].target[classCode=ENC, moodCode=APT]
Encounter.period
DefinitionThe start and end time of the encounter.
Cardinality0...1
TypePeriod
Comments

If not (yet) known, the end of the Period may be omitted.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • per-1:If present, start SHALL have a lower value than end
    start.empty() or end.empty() or (start <= end)
Mappings
  • rim:n/a
  • v2:DR
  • rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2:PV1-44, PV1-45
  • rim:.effectiveTime (low & high)
  • w5:when.done
Encounter.period.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.period.start
DefinitionThe start of the period. The boundary is inclusive.
Cardinality0...1
TypedateTime
SummaryTrue
Comments

If the low element is missing, the meaning is that the low boundary is not known.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:DR.1
  • rim:./low
Encounter.period.end
DefinitionThe end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
Cardinality0...1
TypedateTime
SummaryTrue
Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:DR.2
  • rim:./high
  • api-minsal:fecha_egreso
Encounter.length
DefinitionCantidad de días en que se llevo a cabo el encuentro.
Cardinality0...1
TypeDuration
Comments

May differ from the time the Encounter.period lasted because of leave of absence.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • qty-3:If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • drt-1:There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
    code.exists() implies ((system = %ucum) and value.exists())
Mappings
  • rim:n/a
  • v2:SN (see also Range) or CQ
  • rim:PQ, IVL<PQ>, MO, CO, depending on the values
  • rim:PQ, IVL<PQ> depending on the values
  • v2:(PV1-45 less PV1-44) iff ( (PV1-44 not empty) and (PV1-45 not empty) ); units in minutes
  • rim:.lengthOfStayQuantity
Encounter.reason
DefinitionReason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.
Cardinality0...*
TypeCodeableConcept
Binding

Reason why the encounter takes place.

encounter-reason (preferred)
SummaryTrue
AliasIndication, Admission diagnosis
Comments

For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:EVN-4 / PV2-3 (note: PV2-3 is nominally constrained to inpatient admissions; HL7 v2 makes no vocabulary suggestions for PV2-3; would not expect PV2 segment or PV2-3 to be in use in all implementations )
  • rim:.reasonCode
  • w5:why
Encounter.diagnosis
DefinitionThe list of diagnosis relevant to this encounter.
Cardinality0...*
TypeBackboneElement
SummaryTrue
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.outboundRelationship[typeCode=RSON]
Encounter.diagnosis.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.diagnosis.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.diagnosis.condition
DefinitionReason the encounter takes place, as specified using information from another resource. For admissions, this is the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure.
Cardinality1...1
TypeReference(Condition_egresosHosp_apimin_v3)
AliasAdmission diagnosis, discharge diagnosis, indication
Comments

For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:Resources that would commonly referenced at Encounter.indication would be Condition and/or Procedure. These most closely align with DG1/PRB and PR1 respectively.
  • rim:.outboundRelationship[typeCode=RSON].target
  • w5:why
Encounter.diagnosis.role
DefinitionRole that this diagnosis has within the encounter (e.g. admission, billing, discharge …).
Cardinality0...1
TypeCodeableConcept
Binding

The type of diagnosis this condition represents

diagnosis-role (preferred)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
Encounter.diagnosis.rank
DefinitionRanking of the diagnosis (for each role type).
Cardinality0...1
TypepositiveInt
Comments

32 bit number; for values larger than this, use decimal

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.outboundRelationship[typeCode=RSON].priority
Encounter.account
DefinitionThe set of accounts that may be used for billing for this Encounter.
Cardinality0...*
TypeReference(Account)
Comments

The billing system may choose to allocate billable items associated with the Encounter to different referenced Accounts based on internal business rules.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.pertains.A_Account
Encounter.hospitalization
DefinitionDetails about the admission to a healthcare service.
Cardinality0...1
TypeBackboneElement
Comments

An Encounter may cover more than just the inpatient stay. Contexts such as outpatients, community clinics, and aged care facilities are also included.

The duration recorded in the period of this encounter covers the entire scope of this hospitalization record.

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

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.hospitalization.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.hospitalization.preAdmissionIdentifier
DefinitionPre-admission identifier.
Cardinality0...1
TypeIdentifier
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim:II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd:Identifier
  • v2:PV1-5
  • rim:.id
Encounter.hospitalization.origin
DefinitionThe location from which the patient came before admission.
Cardinality0...1
TypeReference(Location)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.participation[typeCode=ORG].role
Encounter.hospitalization.admitSource
DefinitionFrom where patient was admitted (physician referral, transfer).
Cardinality0...1
TypeCodeableConcept
Binding

From where the patient was admitted.

encounter-admit-source (preferred)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:PV1-14
  • rim:.admissionReferralSourceCode
Encounter.hospitalization.reAdmission
DefinitionWhether this hospitalization is a readmission and why if known.
Cardinality0...1
TypeCodeableConcept
Binding

The reason for re-admission of this hospitalization encounter.

HL7 v2 Value Set 0092 (example)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:PV1-13
Encounter.hospitalization.dietPreference
DefinitionDiet preferences reported by the patient.
Cardinality0...*
TypeCodeableConcept
Binding

Medical, cultural or ethical food preferences to help with catering requirements.

encounter-diet (example)
Requirements

Used to track patient's diet restrictions and/or preference. For a complete description of the nutrition needs of a patient during their stay, one should use the nutritionOrder resource which links to Encounter.

Comments

For example a patient may request both a dairy-free and nut-free diet preference (not mutually exclusive).

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:PV1-38
  • rim:.outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=EVN, code="diet"]
Encounter.hospitalization.specialCourtesy
DefinitionSpecial courtesies (VIP, board member).
Cardinality0...*
TypeCodeableConcept
Binding

Special courtesies

encounter-special-courtesy (preferred)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:PV1-16
  • rim:.specialCourtesiesCode
Encounter.hospitalization.specialArrangement
DefinitionAny special requests that have been made for this hospitalization encounter, such as the provision of specific equipment or other things.
Cardinality0...*
TypeCodeableConcept
Binding

Special arrangements

encounter-special-arrangements (preferred)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:PV1-15 / OBR-30 / OBR-43
  • rim:.specialArrangementCode
Encounter.hospitalization.destination
DefinitionLocation to which the patient is discharged.
Cardinality0...1
TypeReference(Location)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:PV1-37
  • rim:.participation[typeCode=DST]
Encounter.hospitalization.dischargeDisposition
DefinitionCategory or kind of location after discharge.
Cardinality0...1
TypeCodeableConcept
Binding

Discharge Disposition

encounter-discharge-disposition (example)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:PV1-36
  • rim:.dischargeDispositionCode
Encounter.location
DefinitionList of locations where the patient has been during this encounter.
Cardinality0...*
TypeBackboneElement
Comments

Virtual encounters can be recorded in the Encounter by specifying a location reference to a location of type "kind" such as "client's home" and an encounter.class = "virtual".

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

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.location.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.location.location
DefinitionThe location where the encounter takes place.
Cardinality1...1
TypeReference(Location_apimin_v3)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:PV1-3 / PV1-6 / PV1-11 / PV1-42 / PV1-43
  • rim:.role
  • w5:where
Encounter.location.status
DefinitionThe status of the participants' presence at the specified location during the period specified. If the participant is is no longer at the location, then the period will have an end date/time.
Cardinality0...1
Typecode
Binding

The status of the location.

encounter-location-status (required)
Comments

When the patient is no longer active at a location, then the period end date is entered, and the status may be changed to completed.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.role.statusCode
Encounter.location.period
DefinitionTime period during which the patient was present at the location.
Cardinality0...1
TypePeriod
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • per-1:If present, start SHALL have a lower value than end
    start.empty() or end.empty() or (start <= end)
Mappings
  • rim:n/a
  • v2:DR
  • rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • rim:.time
Encounter.serviceProvider
DefinitionAn organization that is in charge of maintaining the information of this Encounter (e.g. who maintains the report or the master service catalog item, etc.). This MAY be the same as the organization on the Patient record, however it could be different. This MAY not be not the Service Delivery Location's Organization.
Cardinality0...1
TypeReference(Organization)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:PV1-10 / PL.6 & PL.1 (note: HL7 v2 definition is "the treatment or type of surgery that the patient is scheduled to receive"; seems slightly out of alignment with the concept name 'hospital service'. Would not trust that implementations apply this semantic by default)
  • rim:.particiaption[typeCode=PFM].role
Encounter.partOf
DefinitionAnother Encounter of which this encounter is a part of (administratively or in time).
Cardinality0...1
TypeReference(Encounter)
Comments

This is also used for associating a child's encounter back to the mother's encounter.

Refer to the Notes section in the Patient resource for further details.

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

Intervenciones Quirurgicas

Aquí se presentan todos los recursos que se utilizaron para mapear la información de las intervenciones quirurgicas.

  1. Definición de estructura para los datos de las intervenciones quirurgicas, aqui se definen principalmente los campos utilizados del recurso Procedure de HL7 FHIR. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/procedureinterqv3.

status
code
display
subjectReference(Patient_apimin_v3)
end

  1. Definición de estructura para los datos del paciente. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/patientapimin.

system
valueS
birthDateS

Búsquedas

Parámetros de Búsqueda Intervenciones Quirúrgicas

Nombre Tipo Descripción Expresión Ejemplo
subject token Utilizado como el rut del paciente sin dígito verificador Procedure.subject subject:Patient.identifier=1111111
_profile token Utilizado como parametro identificador de esquema de datos por minsal y perfil FHIR _profile _profile=http://cens.cl/fhir/StructureDefinition/hospitaldigital-interQuirurgicas

Ejemplos de búsqueda

  • Búsqueda solo por rut
    GET [base]/Procedure?subject:Patient.identifier=12434844&_profile=http://cens.cl/fhir/StructureDefinition/hospitaldigital-interQuirurgicas
    

Ejemplo de response


{
    "resourceType": "Bundle",
    "id": "0920d64e-0ba9-4405-93a9-1c96000caa40",
    "meta": {
        "lastUpdated": "2019-01-14T23:12:24.929-03:00"
    },
    "type": "searchset",
    "total": 1,
    "link": [
        {
            "relation": "self",
            "url": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/Procedure?_profile=http%3A%2F%2Fcens.cl%2Ffhir%2FStructureDefinition%2Fhospitaldigital-interQuirurgicas&subject%3APatient.identifier=12434844"
        }
    ],
    "entry": [
        {
            "fullUrl": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/Procedure/3852914",
            "resource": {
                "resourceType": "Procedure",
                "id": "3852914",
                "contained": [
                    {
                        "resourceType": "Patient",
                        "id": "p1",
                        "identifier": [
                            {
                                "system": "https://www.srcei.cl/RUT",
                                "value": "12434844"
                            }
                        ]
                    }
                ],
                "status": "completed",
                "code": {
                    "coding": [
                        {
                            "code": "1103048",
                            "display": "Neurotomía facetaria percutanea, incluye bloqueo facetario "
                        },
                        {
                            "code": "N/A",
                            "display": "N/A"
                        },
                        {
                            "code": "N/A",
                            "display": "N/A"
                        }
                    ]
                },
                "subject": {
                    "reference": "#p1"
                },
                "performedPeriod": {
                    "end": "2017-08-23T00:00:00-03:00"
                }
            }
        }
    ]
}

Dicccionario de Datos

Diccionario de Procedure

Procedure
DefinitionAn action that is or was performed on a patient. This can be a physical intervention like an operation, or less invasive like counseling or hypnotherapy.
Cardinality0...*
Invariants
  • dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-1:If the resource is contained in another resource, it SHALL NOT contain any narrative
    contained.text.empty()
  • dom-4:If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-3:If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
    contained.where(('#'+id in %resource.descendants().reference).not()).empty()
  • pro-1:Reason not done is only permitted if notDone indicator is true
    notDoneReason.empty() or notDone = true
Mappings
  • rim:Entity. Role, or Act
  • rim:Procedure[moodCode=EVN]
  • w5:clinical.general
Procedure.id
DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality0...1
Typeid
SummaryTrue
Comments

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

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

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

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

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

A human language.

languages (extensible)
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
Procedure.text
DefinitionA human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Cardinality0...1
TypeNarrative
Aliasnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
  • rim:Act.text?
Procedure.contained
DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Cardinality0...*
TypeResource
Aliasinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Procedure.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Procedure.identifier
DefinitionThis records identifiers associated with this procedure that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).
Cardinality0...*
TypeIdentifier
SummaryTrue
Requirements

Need to allow connection to a wider workflow.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim:II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd:Identifier
  • v2:Some combination of ORC-2 / ORC-3 / OBR-2 / OBR-3 / IPC-1 / IPC-2 / IPC-3 / IPC-4
  • rim:.id
  • w5:id
Procedure.definition
DefinitionA protocol, guideline, orderset or other definition that was adhered to in whole or in part by this procedure.
Cardinality0...*
TypeReference(PlanDefinition | ActivityDefinition | HealthcareService)
SummaryTrue
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.outboundRelationship[typeCode=DEFN].target
Procedure.basedOn
DefinitionA reference to a resource that contains details of the request for this procedure.
Cardinality0...*
TypeReference(CarePlan | ProcedureRequest | ReferralRequest)
SummaryTrue
Aliasfulfills
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.outboundRelationship[typeCode=FLFS].target[classCode=(various e.g. PROC, OBS, PCPR, ACT, moodCode=RQO].code
Procedure.partOf
DefinitionA larger event of which this particular procedure is a component or step.
Cardinality0...*
TypeReference(Procedure | Observation | MedicationAdministration)
SummaryTrue
Aliascontainer
Comments

The MedicationAdministration has a partOf reference to Procedure, but this is not a circular reference. For a surgical procedure, the anesthesia related medicationAdministration is part of the procedure. For an IV medication administration, the procedure to insert the IV port is part of the medication administration.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.inboundRelationship[typeCode=COMP].source[classCode=SBADM or PROC or OBS, moodCode=EVN]
Procedure.status
DefinitionSe define el estado del procedimiento.
Cardinality1...1
Typecode
Binding

A code specifying the state of the procedure.

event-status (required)
ModifierTrue
SummaryTrue
Comments

The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure.

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:statusCode
  • w5:status
  • api-minsal:tipo_fuente
Procedure.notDone
DefinitionSet this to true if the record is saying that the procedure was NOT performed.
Cardinality0...1
Typeboolean
ModifierTrue
SummaryTrue
Comments

If true, it means the procedure did not occur as described. Typically it would be accompanied by attributes describing the type of activity. It might also be accompanied by body site information or time information (i.e. no procedure was done to the left arm or no procedure was done in this 2-year period). Specifying additional information such as performer, outcome, etc. is generally inappropriate. For example, it's not that useful to say "There was no appendectomy done at 12:03pm June 6th by Dr. Smith with a successful outcome" as it implies that there could have been an appendectomy done at any other time, by any other clinician or with any other outcome.

This element is labeled as a modifier because it indicates that a procedure didn't happen.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.actionNegationInd
Procedure.notDoneReason
DefinitionA code indicating why the procedure was not performed.
Cardinality0...1
TypeCodeableConcept
Binding

A code that identifies the reason a procedure was not performed.

procedure-not-performed-reason (example)
SummaryTrue
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:.reason.Observation.value
Procedure.category
DefinitionA code that classifies the procedure for searching, sorting and display purposes (e.g. "Surgical Procedure").
Cardinality0...1
TypeCodeableConcept
Binding

A code that classifies a procedure for searching, sorting and display purposes.

procedure-category (example)
SummaryTrue
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:.outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
  • w5:class
Procedure.code
DefinitionThe specific procedure that is performed. Use text if the exact nature of the procedure cannot be coded (e.g. "Laparoscopic Appendectomy").
Cardinality0...1
TypeCodeableConcept
Binding

A code to identify a specific procedure .

procedure-code (example)
SummaryTrue
Aliastype
Requirements

0..1 to account for primarily narrative only resources.

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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:OBR-44/OBR-45
  • rim:.code
  • w5:what
Procedure.code.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Procedure.code.coding
DefinitionCódigos que hacen referencia a algún sistema de codificación.
Cardinality0...*
TypeCoding
SummaryTrue
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE 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
Procedure.code.coding.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Procedure.code.coding.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality0...1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:C*E.3
  • rim:./codeSystem
  • orim:fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Procedure.code.coding.version
DefinitionThe 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.
Cardinality0...1
Typestring
SummaryTrue
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:C*E.7
  • rim:./codeSystemVersion
  • orim:fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Procedure.code.coding.code
DefinitionAquí se ingresa el valor del código de la intervención.
Cardinality0...1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:C*E.1
  • rim:./code
  • orim:fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  • api-minsal:código_intervenciones
Procedure.code.coding.display
DefinitionNombre completo que hace referencia al código de la intervención.
Cardinality0...1
Typestring
SummaryTrue
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 may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:C*E.2 - but note this is not well followed
  • rim:CV.displayName
  • orim:fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
Procedure.code.coding.userSelected
DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
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 ]
Procedure.code.text
DefinitionA 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.
Cardinality0...1
Typestring
SummaryTrue
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
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
Procedure.subject
DefinitionThe person, animal or group on which the procedure was performed.
Cardinality1...1
TypeReference(Patient_apimin_v3)
SummaryTrue
Aliaspatient
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:PID-3
  • rim:.participation[typeCode=SBJ].role
  • w5:who.focus
Procedure.context
DefinitionThe encounter during which the procedure was performed.
Cardinality0...1
TypeReference(Encounter | EpisodeOfCare)
SummaryTrue
Aliasencounter
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:PV1-19
  • rim:.inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
  • w5:context
Procedure.performed[x]:performedPeriod
DefinitionPeriodo durante el cual el procedimiento fue realizado
Cardinality0...1
TypePeriod
SummaryTrue
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:OBR-7
  • rim:.effectiveTime
  • w5:when.done
Procedure.performed[x]:performedPeriod.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Procedure.performed[x]:performedPeriod.start
DefinitionThe start of the period. The boundary is inclusive.
Cardinality0...1
TypedateTime
SummaryTrue
Comments

If the low element is missing, the meaning is that the low boundary is not known.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:DR.1
  • rim:./low
Procedure.performed[x]:performedPeriod.end
DefinitionFecha en que se término el periodo de realización del procedimiento.
Cardinality0...1
TypedateTime
SummaryTrue
Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:DR.2
  • rim:./high
  • api-minsal:fecha_egreso
Procedure.performer
DefinitionLimited to 'real' people rather than equipment.
Cardinality0...*
TypeBackboneElement
SummaryTrue
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.participation[typeCode=PRF]
Procedure.performer.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Procedure.performer.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Procedure.performer.role
DefinitionFor example: surgeon, anaethetist, endoscopist.
Cardinality0...1
TypeCodeableConcept
Binding

A code that identifies the role of a performer of the procedure.

performer-role (example)
SummaryTrue
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:Some combination of STF-18 / PRA-3 / PRT-4 / ROL-3 / ORC-12 / OBR-16 / PV1-7 / PV1-8 / PV1-9 / PV1-17 / OBX-25
  • rim:.functionCode
Procedure.performer.actor
DefinitionThe practitioner who was involved in the procedure.
Cardinality1...1
TypeReference(Practitioner | Organization | Patient | RelatedPerson | Device)
SummaryTrue
Requirements

A reference to Device supports use cases, such as pacemakers.

Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:ORC-19/PRT-5
  • rim:.role
  • w5:who.actor
Procedure.performer.onBehalfOf
DefinitionThe organization the device or practitioner was acting on behalf of.
Cardinality0...1
TypeReference(Organization)
Requirements

Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when performing the action.

Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.scoper
Procedure.location
DefinitionThe location where the procedure actually happened. E.g. a newborn at home, a tracheostomy at a restaurant.
Cardinality0...1
TypeReference(Location)
SummaryTrue
Requirements

Ties a procedure to where the records are likely kept.

Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.participation[typeCode=LOC].role[classCode=SDLOC]
  • w5:where
Procedure.reasonCode
DefinitionThe coded reason why the procedure was performed. This may be coded entity of some type, or may simply be present as text.
Cardinality0...*
TypeCodeableConcept
Binding

A code that identifies the reason a procedure is required.

procedure-reason (example)
SummaryTrue
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:.reasonCode
  • w5:why
Procedure.reasonReference
DefinitionThe condition that is the reason why the procedure was performed.
Cardinality0...*
TypeReference(Condition | Observation)
SummaryTrue
Comments

e.g. endoscopy for dilatation and biopsy, combination diagnosis and therapeutic.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.reasonCode
  • w5:why
Procedure.bodySite
DefinitionDetailed and structured anatomical location information. Multiple locations are allowed - e.g. multiple punch biopsies of a lesion.
Cardinality0...*
TypeCodeableConcept
Binding

Codes describing anatomical locations. May include laterality.

body-site (example)
SummaryTrue
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:OBX-20
  • rim:.targetSiteCode
Procedure.outcome
DefinitionThe outcome of the procedure - did it resolve reasons for the procedure being performed?
Cardinality0...1
TypeCodeableConcept
Binding

An outcome of a procedure - whether it was resolved or otherwise.

procedure-outcome (example)
SummaryTrue
Comments

If outcome contains narrative text only, it can be captured using the CodeableConcept.text.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:.outboundRelationship[typeCode=OUT].target.text
Procedure.report
DefinitionThis could be a histology result, pathology report, surgical report, etc..
Cardinality0...*
TypeReference(DiagnosticReport)
Comments

There could potentially be multiple reports - e.g. if this was a procedure which took multiple biopsies resulting in a number of anatomical pathology reports.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN]
Procedure.complication
DefinitionAny complications that occurred during the procedure, or in the immediate post-performance period. These are generally tracked separately from the notes, which will typically describe the procedure itself rather than any 'post procedure' issues.
Cardinality0...*
TypeCodeableConcept
Binding

Codes describing complications that resulted from a procedure.

condition-code (example)
Comments

If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:.outboundRelationship[typeCode=OUTC].target[classCode=OBS, code="complication", moodCode=EVN].value
Procedure.complicationDetail
DefinitionAny complications that occurred during the procedure, or in the immediate post-performance period.
Cardinality0...*
TypeReference(Condition)
Requirements

This is used to document a condition that is a result of the procedure, not the condition that was the reason for the procedure.

Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.outboundRelationship[typeCode=OUTC].target[classCode=OBS, code="complication", moodCode=EVN].value
Procedure.followUp
DefinitionIf the procedure required specific follow up - e.g. removal of sutures. The followup may be represented as a simple note, or could potentially be more complex in which case the CarePlan resource can be used.
Cardinality0...*
TypeCodeableConcept
Binding

Specific follow up required for a procedure e.g. removal of sutures.

procedure-followup (example)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:.outboundRelationship[typeCode=COMP].target[classCode=ACT, moodCode=INT].code
Procedure.note
DefinitionAny other notes about the procedure. E.g. the operative notes.
Cardinality0...*
TypeAnnotation
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:N/A
  • rim:Act
  • v2:NTE
  • rim:.inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value
Procedure.focalDevice
DefinitionA device that is implanted, removed or otherwise manipulated (calibration, battery replacement, fitting a prosthesis, attaching a wound-vac, etc.) as a focal portion of the Procedure.
Cardinality0...*
TypeBackboneElement
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.participation[typeCode=DEV].role[classCode=MANU]
Procedure.focalDevice.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Procedure.focalDevice.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Procedure.focalDevice.action
DefinitionThe kind of change that happened to the device during the procedure.
Cardinality0...1
TypeCodeableConcept
Binding

A kind of change that happened to the device during the procedure.

device-action (preferred)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:.inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="procedure device action"].value=:procedure device action codes
Procedure.focalDevice.manipulated
DefinitionThe device that was manipulated (changed) during the procedure.
Cardinality1...1
TypeReference(Device)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.participation[typeCode=DEV].role[classCode=SDLOC]
Procedure.usedReference
DefinitionIdentifies medications, devices and any other substance used as part of the procedure.
Cardinality0...*
TypeReference(Device | Medication | Substance)
Requirements

Used for tracking contamination, etc.

Comments

For devices actually implanted or removed, use Procedure.device.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.participation[typeCode=DEV].role[classCode=MANU] or .participation[typeCode=CSM].role[classCode=ADMM] (for Medication or Substance)
Procedure.usedCode
DefinitionIdentifies coded items that were used as part of the procedure.
Cardinality0...*
TypeCodeableConcept
Binding

Codes describing items used during a procedure

device-kind (example)
Comments

For devices actually implanted or removed, use Procedure.device.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:participation[typeCode=Dev].role[classCode=MANU]

Ingresos Urgencias

Aquí se presentan todos los recursos que se utilizaron para mapear la información de los Ingresos de Urgencias.

  1. Definición de estructura para los datos de las ingresos de urgencias, aqui se definen principalmente los campos utilizados del recurso Encounter de HL7 FHIR. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/encounteringresosurgenciasv3.

status
subjectReference(Patient | Patient_apimin_v3)
start
end
text
conditionReference(Condition | Condition_ingresosUrgencias_v3)
locationReference(Location_apimin_v3)

  1. Definición de estructura para los datos del paciente. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/Patientapiminv3.

system
valueS
birthDateS

  1. Definición de estructura para los datos del encuentro. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/encounterapimin.

start
end
text
serviceProviderReference(Organization_apimin)

  1. Definición de estructura para los datos del establecimiento. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/Locationapiminv3.

system
value
name
text

  1. Definición estructura para datos de diagnosticos en ingresos de urgencias. Con mas detalle podemos observar como se exponen los datos en https://simplifier.net/test-api-minsal/ConditioningresosUrgenciasv3.

code
display
textS

Búsquedas

Parámetros de Búsqueda Ingresos Urgencias

Nombre Tipo Descripción Expresión Ejemplo
subject token Utilizado como el rut del paciente sin dígito verificador DiagnosticReport.subject subject.identifier=1111111
_profile token Utilizado como parametro identificador de esquema de datos por minsal y perfil FHIR _profile _profile=http://cens.cl/fhir/StructureDefinition/hospitaldigital-ingresosUrgencia
date date Fecha de atención en formato YYYY-MM-DD Encounter.date date=ge2018-10-12
date=lt2018-10-12
date=2018-10-12

Prefijos implementados para búsquedas por fecha

Expresión Definición Ejemplo Significado
ge Mayor o Igual que ge2018-10-12 Resultados con fecha posterior o igual a 2018-10-12
lt Menor que lt2018-10-12 Resultados con fecha anterior a 2018-10-12

Referencia: Documentación completa en FHIR

Ejemplos de búsqueda

  • Búsqueda solo por rut
    GET [base]/Encounter?subject.identifier=12803572&_profile=http://cens.cl/fhir/StructureDefinition/hospitaldigital-ingresosUrgencia
    
  • Búsqueda por rut y rango de fechas
    GET [base]/Encounter?subject.identifier=12803572&_profile=http://cens.cl/fhir/StructureDefinition/hospitaldigital-ingresosUrgencia&date=ge2016-01-01&date=lt2016-01-18
    

Ejemplo de response

{
    "resourceType": "Bundle",
    "id": "f396846f-d872-498e-aad1-c6dc6470d28a",
    "meta": {
        "lastUpdated": "2019-01-14T23:15:47.781-03:00"
    },
    "type": "searchset",
    "total": 2,
    "link": [
        {
            "relation": "self",
            "url": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/Encounter?_profile=http%3A%2F%2Fcens.cl%2Ffhir%2FStructureDefinition%2Fhospitaldigital-ingresosUrgencia&subject.identifier=12803572"
        }
    ],
    "entry": [
        {
            "fullUrl": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/Encounter/2453",
            "resource": {
                "resourceType": "Encounter",
                "id": "2453",
                "contained": [
                    {
                        "resourceType": "Patient",
                        "id": "p1",
                        "identifier": [
                            {
                                "system": "https://www.srcei.cl/RUT",
                                "value": "12803572"
                            }
                        ]
                    },
                    {
                        "resourceType": "Condition",
                        "id": "con1",
                        "code": {
                            "coding": [
                                {
                                    "code": "A09"
                                },
                                {
                                    "display": "DIARREA Y GASTROENTERITIS DE PRESUNTO ORIGEN INFECCIOSO"
                                }
                            ],
                            "text": "Hipotesis Diagnostica"
                        }
                    },
                    {
                        "resourceType": "Condition",
                        "id": "con2",
                        "code": {
                            "coding": [
                                {
                                    "code": "A09"
                                },
                                {
                                    "display": "DIARREA Y GASTROENTERITIS DE PRESUNTO ORIGEN INFECCIOSO"
                                }
                            ],
                            "text": "Diagnostico Final"
                        }
                    },
                    {
                        "resourceType": "Location",
                        "id": "loc",
                        "identifier": [
                            {
                                "system": "http://www.deis.cl",
                                "value": "101303"
                            }
                        ],
                        "name": "Centro de Salud Familiar Iris Véliz Hume (Ex Oriente)"
                    }
                ],
                "status": "?",
                "subject": {
                    "reference": "#p1"
                },
                "period": {
                    "start": "2016-01-10T00:00:00-03:00",
                    "end": "2016-01-10T00:00:00-03:00"
                },
                "reason": [
                    {
                        "text": "VOMITOS NAUSEAS DOLOR DE CABEZA"
                    }
                ],
                "diagnosis": [
                    {
                        "condition": {
                            "reference": "#con1"
                        }
                    },
                    {
                        "condition": {
                            "reference": "#con2"
                        }
                    }
                ],
                "location": [
                    {
                        "location": {
                            "reference": "#loc"
                        }
                    }
                ]
            }
        },
        {
            "fullUrl": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/Encounter/2454",
            "resource": {
                "resourceType": "Encounter",
                "id": "2454",
                "contained": [
                    {
                        "resourceType": "Patient",
                        "id": "p1",
                        "identifier": [
                            {
                                "system": "https://www.srcei.cl/RUT",
                                "value": "12803572"
                            }
                        ]
                    },
                    {
                        "resourceType": "Condition",
                        "id": "con1",
                        "code": {
                            "text": "Hipotesis Diagnostica"
                        }
                    },
                    {
                        "resourceType": "Condition",
                        "id": "con2",
                        "code": {
                            "text": "Diagnostico Final"
                        }
                    },
                    {
                        "resourceType": "Location",
                        "id": "loc",
                        "identifier": [
                            {
                                "system": "http://www.deis.cl",
                                "value": "101303"
                            }
                        ],
                        "name": "Centro de Salud Familiar Iris Véliz Hume (Ex Oriente)"
                    }
                ],
                "status": "?",
                "subject": {
                    "reference": "#p1"
                },
                "period": {
                    "start": "2016-01-19T00:00:00-03:00",
                    "end": "2016-01-19T00:00:00-03:00"
                },
                "reason": [
                    {
                        "text": "DOLOR AL ORINAR Y DOLOR DE ESPALDA, Y VOMITO"
                    }
                ],
                "diagnosis": [
                    {
                        "condition": {
                            "reference": "#con1"
                        }
                    },
                    {
                        "condition": {
                            "reference": "#con2"
                        }
                    }
                ],
                "location": [
                    {
                        "location": {
                            "reference": "#loc"
                        }
                    }
                ]
            }
        }
    ]
}

Dicccionario de Datos

Diccionario de Encounter

Encounter
DefinitionAn interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient.
Cardinality0...*
AliasVisit
Invariants
  • dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-1:If the resource is contained in another resource, it SHALL NOT contain any narrative
    contained.text.empty()
  • dom-4:If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-3:If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
    contained.where(('#'+id in %resource.descendants().reference).not()).empty()
Mappings
  • rim:Entity. Role, or Act
  • rim:Encounter[@moodCode='EVN']
  • w5:workflow.encounter
Encounter.id
DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality0...1
Typeid
SummaryTrue
Comments

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

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

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

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

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

A human language.

languages (extensible)
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
Encounter.text
DefinitionA human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Cardinality0...1
TypeNarrative
Aliasnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
  • rim:Act.text?
Encounter.contained
DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Cardinality0...*
TypeResource
Aliasinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.identifier
DefinitionIdentifier(s) by which this encounter is known.
Cardinality0...*
TypeIdentifier
SummaryTrue
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim:II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd:Identifier
  • v2:PV1-19
  • rim:.id
  • w5:id
Encounter.status
DefinitionSe define el estado del encuentro.
Cardinality1...1
Typecode
Binding

Current state of the encounter

encounter-status (required)
ModifierTrue
SummaryTrue
Comments

Note that internal business rules will detemine the appropraite transitions that may occur between statuses (and also classes).

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:No clear equivalent in HL7 v2; active/finished could be inferred from PV1-44, PV1-45, PV2-24; inactive could be inferred from PV2-16
  • rim:.statusCode
  • w5:status
  • api-minsal:tipo_fuente
Encounter.statusHistory
DefinitionThe status history permits the encounter resource to contain the status history without needing to read through the historical versions of the resource, or even have the server store them.
Cardinality0...*
TypeBackboneElement
Comments

The current status is always found in the current version of the resource, not the status history.

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

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.statusHistory.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.statusHistory.status
Definitionplanned | arrived | triaged | in-progress | onleave | finished | cancelled +.
Cardinality1...1
Typecode
Binding

Current state of the encounter

encounter-status (required)
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
Encounter.statusHistory.period
DefinitionThe time that the episode was in the specified status.
Cardinality1...1
TypePeriod
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • per-1:If present, start SHALL have a lower value than end
    start.empty() or end.empty() or (start <= end)
Mappings
  • rim:n/a
  • v2:DR
  • rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
Encounter.class
Definitioninpatient | outpatient | ambulatory | emergency +.
Cardinality0...1
TypeCoding
Binding

Classification of the encounter

HL7 v3 Value Set ActEncounterCode (extensible)
SummaryTrue
Comments

Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim:CV
  • orim:fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2:PV1-2
  • rim:.inboundRelationship[typeCode=SUBJ].source[classCode=LIST].code
  • w5:class
Encounter.classHistory
DefinitionThe class history permits the tracking of the encounters transitions without needing to go through the resource history. This would be used for a case where an admission starts of as an emergency encounter, then transisions into an inpatient scenario. Doing this and not restarting a new encounter ensures that any lab/diagnostic results can more easily follow the patient and not require re-processing and not get lost or cancelled during a kindof discharge from emergency to inpatient.
Cardinality0...*
TypeBackboneElement
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
Encounter.classHistory.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.classHistory.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.classHistory.class
Definitioninpatient | outpatient | ambulatory | emergency +.
Cardinality1...1
TypeCoding
Binding

Classification of the encounter

HL7 v3 Value Set ActEncounterCode (extensible)
Comments

Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim:CV
  • orim:fhir:Coding rdfs:subClassOf dt:CDCoding
Encounter.classHistory.period
DefinitionThe time that the episode was in the specified class.
Cardinality1...1
TypePeriod
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • per-1:If present, start SHALL have a lower value than end
    start.empty() or end.empty() or (start <= end)
Mappings
  • rim:n/a
  • v2:DR
  • rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
Encounter.type
DefinitionSpecific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation).
Cardinality0...*
TypeCodeableConcept
Binding

The type of encounter

encounter-type (example)
SummaryTrue
Comments

Since there are many ways to further classify encounters, this element is 0..*.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:PV1-4 / PV1-18
  • rim:.code
  • w5:class
Encounter.priority
DefinitionIndicates the urgency of the encounter.
Cardinality0...1
TypeCodeableConcept
Binding

Indicates the urgency of the encounter.

HL7 v3 Value Set ActPriority (example)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:PV2-25
  • rim:.priorityCode
  • w5:grade
Encounter.subject
DefinitionThe patient ro group present at the encounter.
Cardinality0...1
TypeReference(Patient | Patient_apimin_v3)
SummaryTrue
Aliaspatient
Comments

While the encounter is always about the patient, the patient may not actually be known in all contexts of use, and there may be a group of patients that could be anonymous (such as in a group therapy for Alcoholics Anonymous - where the recording of the encounter could be used for billing on the number of people/staff and not important to the context of the specific patients) or alternately in veterinary care a herd of sheep receiving treatment (where the animals are not individually tracked).

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:PID-3
  • rim:.participation[typeCode=SBJ]/role[classCode=PAT]
  • w5:who.focus
Encounter.episodeOfCare
DefinitionWhere a specific encounter should be classified as a part of a specific episode(s) of care this field should be used. This association can facilitate grouping of related encounters together for a specific purpose, such as government reporting, issue tracking, association via a common problem. The association is recorded on the encounter as these are typically created after the episode of care, and grouped on entry rather than editing the episode of care to append another encounter to it (the episode of care could span years).
Cardinality0...*
TypeReference(EpisodeOfCare)
SummaryTrue
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:PV1-54, PV1-53
  • w5:context
Encounter.incomingReferral
DefinitionThe referral request this encounter satisfies (incoming referral).
Cardinality0...*
TypeReference(ReferralRequest)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.reason.ClinicalDocument
Encounter.participant
DefinitionThe list of people responsible for providing the service.
Cardinality0...*
TypeBackboneElement
SummaryTrue
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:ROL
  • rim:.participation[typeCode=PFM]
Encounter.participant.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.participant.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.participant.type
DefinitionRole of participant in encounter.
Cardinality0...*
TypeCodeableConcept
Binding

Role of participant in encounter

encounter-participant-type (extensible)
SummaryTrue
Comments

The participant type indicates how an individual partitipates in an encounter. It includes non-practitioner participants, and for practitioners this is to describe the action type in the context of this encounter (e.g. Admitting Dr, Attending Dr, Translator, Consulting Dr). This is different to the practitioner roles which are functional roles, derived from terms of employment, education, licensing, etc.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:ROL-3 (or maybe PRT-4)
  • rim:.functionCode
Encounter.participant.period
DefinitionThe period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period.
Cardinality0...1
TypePeriod
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • per-1:If present, start SHALL have a lower value than end
    start.empty() or end.empty() or (start <= end)
Mappings
  • rim:n/a
  • v2:DR
  • rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2:ROL-5, ROL-6 (or maybe PRT-5)
  • rim:.time
Encounter.participant.individual
DefinitionPersons involved in the encounter other than the patient.
Cardinality0...1
TypeReference(Practitioner | RelatedPerson)
SummaryTrue
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:ROL-4
  • rim:.role
  • w5:who
Encounter.appointment
DefinitionThe appointment that scheduled this encounter.
Cardinality0...1
TypeReference(Appointment)
SummaryTrue
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:SCH-1 / SCH-2
  • rim:.outboundRelationship[typeCode=FLFS].target[classCode=ENC, moodCode=APT]
Encounter.period
DefinitionThe start and end time of the encounter.
Cardinality0...1
TypePeriod
Comments

If not (yet) known, the end of the Period may be omitted.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • per-1:If present, start SHALL have a lower value than end
    start.empty() or end.empty() or (start <= end)
Mappings
  • rim:n/a
  • v2:DR
  • rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2:PV1-44, PV1-45
  • rim:.effectiveTime (low & high)
  • w5:when.done
Encounter.period.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.period.start
DefinitionFecha en la cual comienza la atención del paciente.
Cardinality0...1
TypedateTime
SummaryTrue
Comments

If the low element is missing, the meaning is that the low boundary is not known.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:DR.1
  • rim:./low
  • api-minsal:fecha_atencion
Encounter.period.end
DefinitionFecha en la cual finaliza la atención del paciente (Fecha de alta médica).
Cardinality0...1
TypedateTime
SummaryTrue
Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:DR.2
  • rim:./high
  • api-minsal:fecha_alta
Encounter.length
DefinitionQuantity of time the encounter lasted. This excludes the time during leaves of absence.
Cardinality0...1
TypeDuration
Comments

May differ from the time the Encounter.period lasted because of leave of absence.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • qty-3:If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • drt-1:There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
    code.exists() implies ((system = %ucum) and value.exists())
Mappings
  • rim:n/a
  • v2:SN (see also Range) or CQ
  • rim:PQ, IVL<PQ>, MO, CO, depending on the values
  • rim:PQ, IVL<PQ> depending on the values
  • v2:(PV1-45 less PV1-44) iff ( (PV1-44 not empty) and (PV1-45 not empty) ); units in minutes
  • rim:.lengthOfStayQuantity
Encounter.reason
DefinitionReason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.
Cardinality0...*
TypeCodeableConcept
Binding

Reason why the encounter takes place.

encounter-reason (preferred)
SummaryTrue
AliasIndication, Admission diagnosis
Comments

For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:EVN-4 / PV2-3 (note: PV2-3 is nominally constrained to inpatient admissions; HL7 v2 makes no vocabulary suggestions for PV2-3; would not expect PV2 segment or PV2-3 to be in use in all implementations )
  • rim:.reasonCode
  • w5:why
Encounter.reason.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.reason.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality0...*
TypeCoding
SummaryTrue
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE 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
Encounter.reason.text
DefinitionRazón por la cual el paciente acude al centro de atención.
Cardinality0...1
Typestring
SummaryTrue
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
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
  • api-minsal:mot_consulta
Encounter.diagnosis
DefinitionThe list of diagnosis relevant to this encounter.
Cardinality0...*
TypeBackboneElement
SummaryTrue
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.outboundRelationship[typeCode=RSON]
Encounter.diagnosis.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.diagnosis.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.diagnosis.condition
DefinitionReason the encounter takes place, as specified using information from another resource. For admissions, this is the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure.
Cardinality1...1
TypeReference(Condition | Condition_ingresosUrgencias_v3)
AliasAdmission diagnosis, discharge diagnosis, indication
Comments

For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:Resources that would commonly referenced at Encounter.indication would be Condition and/or Procedure. These most closely align with DG1/PRB and PR1 respectively.
  • rim:.outboundRelationship[typeCode=RSON].target
  • w5:why
Encounter.diagnosis.role
DefinitionRole that this diagnosis has within the encounter (e.g. admission, billing, discharge …).
Cardinality0...1
TypeCodeableConcept
Binding

The type of diagnosis this condition represents

diagnosis-role (preferred)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
Encounter.diagnosis.rank
DefinitionRanking of the diagnosis (for each role type).
Cardinality0...1
TypepositiveInt
Comments

32 bit number; for values larger than this, use decimal

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.outboundRelationship[typeCode=RSON].priority
Encounter.account
DefinitionThe set of accounts that may be used for billing for this Encounter.
Cardinality0...*
TypeReference(Account)
Comments

The billing system may choose to allocate billable items associated with the Encounter to different referenced Accounts based on internal business rules.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.pertains.A_Account
Encounter.hospitalization
DefinitionDetails about the admission to a healthcare service.
Cardinality0...1
TypeBackboneElement
Comments

An Encounter may cover more than just the inpatient stay. Contexts such as outpatients, community clinics, and aged care facilities are also included.

The duration recorded in the period of this encounter covers the entire scope of this hospitalization record.

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

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.hospitalization.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.hospitalization.preAdmissionIdentifier
DefinitionPre-admission identifier.
Cardinality0...1
TypeIdentifier
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim:II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd:Identifier
  • v2:PV1-5
  • rim:.id
Encounter.hospitalization.origin
DefinitionThe location from which the patient came before admission.
Cardinality0...1
TypeReference(Location)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.participation[typeCode=ORG].role
Encounter.hospitalization.admitSource
DefinitionFrom where patient was admitted (physician referral, transfer).
Cardinality0...1
TypeCodeableConcept
Binding

From where the patient was admitted.

encounter-admit-source (preferred)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:PV1-14
  • rim:.admissionReferralSourceCode
Encounter.hospitalization.reAdmission
DefinitionWhether this hospitalization is a readmission and why if known.
Cardinality0...1
TypeCodeableConcept
Binding

The reason for re-admission of this hospitalization encounter.

HL7 v2 Value Set 0092 (example)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:PV1-13
Encounter.hospitalization.dietPreference
DefinitionDiet preferences reported by the patient.
Cardinality0...*
TypeCodeableConcept
Binding

Medical, cultural or ethical food preferences to help with catering requirements.

encounter-diet (example)
Requirements

Used to track patient's diet restrictions and/or preference. For a complete description of the nutrition needs of a patient during their stay, one should use the nutritionOrder resource which links to Encounter.

Comments

For example a patient may request both a dairy-free and nut-free diet preference (not mutually exclusive).

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:PV1-38
  • rim:.outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=EVN, code="diet"]
Encounter.hospitalization.specialCourtesy
DefinitionSpecial courtesies (VIP, board member).
Cardinality0...*
TypeCodeableConcept
Binding

Special courtesies

encounter-special-courtesy (preferred)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:PV1-16
  • rim:.specialCourtesiesCode
Encounter.hospitalization.specialArrangement
DefinitionAny special requests that have been made for this hospitalization encounter, such as the provision of specific equipment or other things.
Cardinality0...*
TypeCodeableConcept
Binding

Special arrangements

encounter-special-arrangements (preferred)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:PV1-15 / OBR-30 / OBR-43
  • rim:.specialArrangementCode
Encounter.hospitalization.destination
DefinitionLocation to which the patient is discharged.
Cardinality0...1
TypeReference(Location)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:PV1-37
  • rim:.participation[typeCode=DST]
Encounter.hospitalization.dischargeDisposition
DefinitionCategory or kind of location after discharge.
Cardinality0...1
TypeCodeableConcept
Binding

Discharge Disposition

encounter-discharge-disposition (example)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:PV1-36
  • rim:.dischargeDispositionCode
Encounter.location
DefinitionList of locations where the patient has been during this encounter.
Cardinality0...*
TypeBackboneElement
Comments

Virtual encounters can be recorded in the Encounter by specifying a location reference to a location of type "kind" such as "client's home" and an encounter.class = "virtual".

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

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.location.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Encounter.location.location
DefinitionThe location where the encounter takes place.
Cardinality1...1
TypeReference(Location_apimin_v3)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:PV1-3 / PV1-6 / PV1-11 / PV1-42 / PV1-43
  • rim:.role
  • w5:where
Encounter.location.status
DefinitionThe status of the participants' presence at the specified location during the period specified. If the participant is is no longer at the location, then the period will have an end date/time.
Cardinality0...1
Typecode
Binding

The status of the location.

encounter-location-status (required)
Comments

When the patient is no longer active at a location, then the period end date is entered, and the status may be changed to completed.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.role.statusCode
Encounter.location.period
DefinitionTime period during which the patient was present at the location.
Cardinality0...1
TypePeriod
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • per-1:If present, start SHALL have a lower value than end
    start.empty() or end.empty() or (start <= end)
Mappings
  • rim:n/a
  • v2:DR
  • rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • rim:.time
Encounter.serviceProvider
DefinitionAn organization that is in charge of maintaining the information of this Encounter (e.g. who maintains the report or the master service catalog item, etc.). This MAY be the same as the organization on the Patient record, however it could be different. This MAY not be not the Service Delivery Location's Organization.
Cardinality0...1
TypeReference(Organization)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:PV1-10 / PL.6 & PL.1 (note: HL7 v2 definition is "the treatment or type of surgery that the patient is scheduled to receive"; seems slightly out of alignment with the concept name 'hospital service'. Would not trust that implementations apply this semantic by default)
  • rim:.particiaption[typeCode=PFM].role
Encounter.partOf
DefinitionAnother Encounter of which this encounter is a part of (administratively or in time).
Cardinality0...1
TypeReference(Encounter)
Comments

This is also used for associating a child's encounter back to the mother's encounter.

Refer to the Notes section in the Patient resource for further details.

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

FOFAR Medicamentos Programados y Dispensados

Aquí se presentan todos los recursos que se utilizaron para mapear la información de FOFAR Medicamentos Programados y Dispensados.

  1. Definición de estructura para los datos de FOFAR Medicamentos Programados y Dispensados, aqui se definen principalmente los campos utilizados del recurso MedicationRequest de HL7 FHIR. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/medicationrequestmedicamentosv3.

medicationReferenceReference(Medication_apimin)
subjectReference(Patient_apimin_v3)
authoredOn
rateQuantitySimpleQuantity
rateRatioRatio_apimin_v3
end
numberOfRepeatsAllowed

  1. Definición de estructura para los datos del paciente. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/patientapimin.

system
valueS
birthDateS

  1. Definición de estructura para los datos de los medicamentos. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/medicationapiminv3.

system
code
text

  1. Definición del tipo de dato Ratio para la utilización en MedicationRequest. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/ratioapiminv3.

value
value

Búsquedas

Parámetros de Búsqueda Medicamentos

Nombre Tipo Descripción Expresión Ejemplo
patient token Utilizado como el rut del paciente sin dígito verificador MedicationRequest.subject patient.identifier=1111111
authoredOn date Fecha de la emisión de la receta YYYY-MM-DD MedicationRequest.authoredOn date=2018-10-12 date=ge2018-10-12 date=lt2018-10-12

Prefijos implementados para búsquedas por fecha

Expresión Definición Ejemplo Significado
ge Mayor o Igual que ge2018-10-12 Resultados con fecha posterior o igual a 2018-10-12
lt Menor que lt2018-10-12 Resultados con fecha anterior a 2018-10-12

Ejemplos de búsqueda

  • Búsqueda solo por rut
    GET [base]/MedicationRequest?patient.identifer=10029459
    
  • Búsqueda por rut y rango de fechas
    GET [base]/MedicationRequest?patient.identifer=10029459&authoredon=ge2014-04-24&authoredon=lt2018-01-03
    

Referencia: Documentación completa en FHIR

Ejemplo de response

{
    "resourceType": "Bundle",
    "id": "fb23e782-b968-4aa5-80d5-2af06ebac9dc",
    "meta": {
        "lastUpdated": "2019-01-14T23:28:33.363-03:00"
    },
    "type": "searchset",
    "total": 5,
    "link": [
        {
            "relation": "self",
            "url": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/MedicationRequest?authoredon=ge2017-11-24&authoredon=lt2017-12-24&patient.identifer=10029459"
        }
    ],
    "entry": [
        {
            "fullUrl": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/MedicationRequest/35387266",
            "resource": {
                "resourceType": "MedicationRequest",
                "id": "35387266",
                "contained": [
                    {
                        "resourceType": "Medication",
                        "id": "med1",
                        "code": {
                            "coding": [
                                {
                                    "system": "https://www.whocc.no/atc_ddd_index/",
                                    "code": "C08CA05"
                                },
                                {
                                    "system": "http://www.minsal.cl/",
                                    "code": "1951"
                                }
                            ],
                            "text": "nifedipino 20 mg comprimido liberación modificada"
                        }
                    },
                    {
                        "resourceType": "Patient",
                        "id": "p1",
                        "identifier": [
                            {
                                "system": "https://www.srcei.cl/RUT",
                                "value": "10029459"
                            }
                        ]
                    }
                ],
                "medicationReference": {
                    "reference": "#med1"
                },
                "subject": {
                    "reference": "#p1"
                },
                "authoredOn": "2017-12-23T00:00:00-03:00",
                "dosageInstruction": [
                    {
                        "rateRatio": {
                            "numerator": {
                                "value": 1,
                                "unit": "Dosis"
                            },
                            "denominator": {
                                "value": 2,
                                "unit": "Frecuencia"
                            }
                        }
                    }
                ],
                "dispenseRequest": {
                    "validityPeriod": {
                        "end": "2018-12-23T00:00:00-03:00"
                    },
                    "numberOfRepeatsAllowed": 23
                }
            }
        },
        {
            "fullUrl": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/MedicationRequest/35387271",
            "resource": {
                "resourceType": "MedicationRequest",
                "id": "35387271",
                "contained": [
                    {
                        "resourceType": "Medication",
                        "id": "med1",
                        "code": {
                            "coding": [
                                {
                                    "system": "https://www.whocc.no/atc_ddd_index/",
                                    "code": "C03AA03"
                                },
                                {
                                    "system": "http://www.minsal.cl/",
                                    "code": "1805"
                                }
                            ],
                            "text": "hidroclorotiazida 50 mg comprimido"
                        }
                    },
                    {
                        "resourceType": "Patient",
                        "id": "p1",
                        "identifier": [
                            {
                                "system": "https://www.srcei.cl/RUT",
                                "value": "10029459"
                            }
                        ]
                    }
                ],
                "medicationReference": {
                    "reference": "#med1"
                },
                "subject": {
                    "reference": "#p1"
                },
                "authoredOn": "2017-12-23T00:00:00-03:00",
                "dosageInstruction": [
                    {
                        "rateRatio": {
                            "numerator": {
                                "value": 0,
                                "unit": "Dosis"
                            },
                            "denominator": {
                                "value": 1,
                                "unit": "Frecuencia"
                            }
                        }
                    }
                ],
                "dispenseRequest": {
                    "validityPeriod": {
                        "end": "2018-12-23T00:00:00-03:00"
                    },
                    "numberOfRepeatsAllowed": 23
                }
            }
        },
        {
            "fullUrl": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/MedicationRequest/35387290",
            "resource": {
                "resourceType": "MedicationRequest",
                "id": "35387290",
                "contained": [
                    {
                        "resourceType": "Medication",
                        "id": "med1",
                        "code": {
                            "coding": [
                                {
                                    "system": "https://www.whocc.no/atc_ddd_index/",
                                    "code": "B01AC06"
                                },
                                {
                                    "system": "http://www.minsal.cl/",
                                    "code": "1968"
                                }
                            ],
                            "text": "ácido acetilsalicílico 100 mg comprimido"
                        }
                    },
                    {
                        "resourceType": "Patient",
                        "id": "p1",
                        "identifier": [
                            {
                                "system": "https://www.srcei.cl/RUT",
                                "value": "10029459"
                            }
                        ]
                    }
                ],
                "medicationReference": {
                    "reference": "#med1"
                },
                "subject": {
                    "reference": "#p1"
                },
                "authoredOn": "2017-12-23T00:00:00-03:00",
                "dosageInstruction": [
                    {
                        "rateRatio": {
                            "numerator": {
                                "value": 1,
                                "unit": "Dosis"
                            },
                            "denominator": {
                                "value": 1,
                                "unit": "Frecuencia"
                            }
                        }
                    }
                ],
                "dispenseRequest": {
                    "validityPeriod": {
                        "end": "2018-12-23T00:00:00-03:00"
                    },
                    "numberOfRepeatsAllowed": 23
                }
            }
        },
        {
            "fullUrl": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/MedicationRequest/35387343",
            "resource": {
                "resourceType": "MedicationRequest",
                "id": "35387343",
                "contained": [
                    {
                        "resourceType": "Medication",
                        "id": "med1",
                        "code": {
                            "coding": [
                                {
                                    "system": "https://www.whocc.no/atc_ddd_index/",
                                    "code": "C09CA01"
                                },
                                {
                                    "system": "http://www.minsal.cl/",
                                    "code": "1692"
                                }
                            ],
                            "text": "losartán potásico 50 mg comprimido"
                        }
                    },
                    {
                        "resourceType": "Patient",
                        "id": "p1",
                        "identifier": [
                            {
                                "system": "https://www.srcei.cl/RUT",
                                "value": "10029459"
                            }
                        ]
                    }
                ],
                "medicationReference": {
                    "reference": "#med1"
                },
                "subject": {
                    "reference": "#p1"
                },
                "authoredOn": "2017-12-23T00:00:00-03:00",
                "dosageInstruction": [
                    {
                        "rateRatio": {
                            "numerator": {
                                "value": 1,
                                "unit": "Dosis"
                            },
                            "denominator": {
                                "value": 2,
                                "unit": "Frecuencia"
                            }
                        }
                    }
                ],
                "dispenseRequest": {
                    "validityPeriod": {
                        "end": "2018-12-23T00:00:00-03:00"
                    },
                    "numberOfRepeatsAllowed": 23
                }
            }
        },
        {
            "fullUrl": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/MedicationRequest/35387605",
            "resource": {
                "resourceType": "MedicationRequest",
                "id": "35387605",
                "contained": [
                    {
                        "resourceType": "Medication",
                        "id": "med1",
                        "code": {
                            "coding": [
                                {
                                    "system": "https://www.whocc.no/atc_ddd_index/",
                                    "code": "A10BA02"
                                },
                                {
                                    "system": "http://www.minsal.cl/",
                                    "code": "88"
                                }
                            ],
                            "text": "metformina 850 mg comprimido"
                        }
                    },
                    {
                        "resourceType": "Patient",
                        "id": "p1",
                        "identifier": [
                            {
                                "system": "https://www.srcei.cl/RUT",
                                "value": "10029459"
                            }
                        ]
                    }
                ],
                "medicationReference": {
                    "reference": "#med1"
                },
                "subject": {
                    "reference": "#p1"
                },
                "authoredOn": "2017-12-23T00:00:00-03:00",
                "dosageInstruction": [
                    {
                        "rateRatio": {
                            "numerator": {
                                "value": 1,
                                "unit": "Dosis"
                            },
                            "denominator": {
                                "value": 2,
                                "unit": "Frecuencia"
                            }
                        }
                    }
                ],
                "dispenseRequest": {
                    "validityPeriod": {
                        "end": "2018-12-23T00:00:00-03:00"
                    },
                    "numberOfRepeatsAllowed": 23
                }
            }
        }
    ]
}

Dicccionario de Datos

Diccionario de MedicationRequest

MedicationRequest
DefinitionAn order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.
Cardinality0...*
AliasPrescription, Order
Invariants
  • dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-1:If the resource is contained in another resource, it SHALL NOT contain any narrative
    contained.text.empty()
  • dom-4:If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-3:If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
    contained.where(('#'+id in %resource.descendants().reference).not()).empty()
Mappings
  • rim:Entity. Role, or Act
  • workflow:..Request
  • script10.6:Message/Body/NewRx
  • rim:CombinedMedicationRequest
  • w5:clinical.medication
MedicationRequest.id
DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality0...1
Typeid
SummaryTrue
Comments

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

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

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

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

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

A human language.

languages (extensible)
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
MedicationRequest.text
DefinitionA human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Cardinality0...1
TypeNarrative
Aliasnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
  • rim:Act.text?
MedicationRequest.contained
DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Cardinality0...*
TypeResource
Aliasinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
MedicationRequest.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
MedicationRequest.identifier
DefinitionThis records identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. For example a re-imbursement system might issue its own id for each prescription that is created. This is particularly important where FHIR only provides part of an entire workflow process where records must be tracked through an entire system.
Cardinality0...*
TypeIdentifier
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim:II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd:Identifier
  • workflow:…identifer
  • script10.6:Message/Header/PrescriberOrderNumber
  • v2:ORC-2-Placer Order Number / ORC-3-Filler Order Number
  • rim:.id
  • w5:id
MedicationRequest.definition
DefinitionProtocol or definition followed by this request.
Cardinality0...*
TypeReference(ActivityDefinition | PlanDefinition)
SummaryTrue
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow:…definition
  • rim:.outboundRelationship[typeCode=DEFN].target[classCode=unspecified]
MedicationRequest.basedOn
DefinitionA plan or request that is fulfilled in whole or in part by this medication request.
Cardinality0...*
TypeReference(CarePlan | MedicationRequest | ProcedureRequest | ReferralRequest)
SummaryTrue
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow:…basedOn
  • rim:.outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]
MedicationRequest.groupIdentifier
DefinitionA shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription.
Cardinality0...1
TypeIdentifier
SummaryTrue
Requirements

Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim:II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd:Identifier
  • workflow:…groupIdentifier
  • rim:.outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id
MedicationRequest.status
DefinitionA code specifying the current state of the order. Generally this will be active or completed state.
Cardinality0...1
Typecode
Binding

A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription

medication-request-status (required)
ModifierTrue
SummaryTrue
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • workflow:…status
  • script10.6:no mapping
  • rim:.statusCode
  • w5:status
MedicationRequest.intent
DefinitionWhether the request is a proposal, plan, or an original order.
Cardinality1...1
Typecode
Binding

The kind of medication order

medication-request-intent (required)
ModifierTrue
SummaryTrue
Comments

It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only.

An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record.

This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • workflow:…intent
  • rim:.moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)
  • w5:class
MedicationRequest.category
DefinitionIndicates the type of medication order and where the medication is expected to be consumed or administered.
Cardinality0...1
TypeCodeableConcept
Binding

A coded concept identifying where the medication ordered is expected to be consumed or administered

medication-request-category (preferred)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • script10.6:Message/Body/NewRx/MedicationPrescribed/Directions or Message/Body/NewRx/MedicationPrescribed/StructuredSIG
  • rim:.inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value
  • w5:class
MedicationRequest.priority
DefinitionIndicates how quickly the Medication Request should be addressed with respect to other requests.
Cardinality0...1
Typecode
Binding

Identifies the level of importance to be assigned to actioning the request

medication-request-priority (required)
SummaryTrue
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • workflow:…priority
  • rim:.priorityCode
  • w5:grade
MedicationRequest.medication[x]:medicationReference
DefinitionIdentifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.
Cardinality1...1
TypeReference(Medication_apimin)
Binding

A coded concept identifying substance or product that can be ordered.

medication-codes (example)
SummaryTrue
Comments

If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended.  For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource. .

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • workflow:…code
  • script10.6:Message/Body/NewRx/MedicationPrescribed Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription
  • v2:RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code
  • rim:consumable.administrableMedication
  • w5:what
MedicationRequest.subject
DefinitionReferencia a quien se le entrega el medicamento.
Cardinality1...1
TypeReference(Patient_apimin_v3)
SummaryTrue
Comments

The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow:…subject
  • script10.6:Message/Body/NewRx/Patient (need detail to link to specific patient … Patient.Identification in SCRIPT)
  • v2:PID-3-Patient ID List
  • rim:.participation[typeCode=AUT].role
  • w5:who.focus
MedicationRequest.context
DefinitionA link to an encounter, or episode of care, that identifies the particular occurrence or set occurrences of contact between patient and health care provider.
Cardinality0...1
TypeReference(Encounter | EpisodeOfCare)
Comments

SubstanceAdministration->component->EncounterEvent.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow:…context
  • script10.6:no mapping
  • v2:PV1-19-Visit Number
  • rim:.inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
  • w5:context
MedicationRequest.supportingInformation
DefinitionInclude additional information (for example, patient height and weight) that supports the ordering of the medication.
Cardinality0...*
TypeReference(Resource)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]
  • w5:context
MedicationRequest.authoredOn
DefinitionFecha en que el médico emitió la receta.
Cardinality0...1
TypedateTime
SummaryTrue
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • workflow:…authoredOn
  • script10.6:Message/Body/NewRx/MedicationPrescribed/WrittenDate
  • v2:RXE-32-Original Order Date/Time / ORC-9-Date/Time of Transaction
  • rim:author.time
  • w5:when.recorded
  • api-minsal:FEC_EMI_RECETA
MedicationRequest.requester
DefinitionThe individual, organization or device that initiated the request and has responsibility for its activation.
Cardinality0...1
TypeBackboneElement
SummaryTrue
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • mps-1:onBehalfOf can only be specified if agent is practitioner or device
    (agent.resolve().empty()) or (agent.resolve() is Device) or (agent.resolve() is Practitioner) or onBehalfOf.exists().not()
Mappings
  • rim:n/a
  • workflow:…requester
  • rim:.participation[typeCode=AUT].role
  • w5:who.author
MedicationRequest.requester.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
MedicationRequest.requester.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
MedicationRequest.requester.agent
DefinitionThe healthcare professional responsible for authorizing the initial prescription.
Cardinality1...1
TypeReference(Practitioner | Organization | Patient | RelatedPerson | Device)
SummaryTrue
Comments

It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow:….agent
  • script10.6:Message/Body/NewRx/Prescriber (need detail to link to specific prescriber … Prescriber.Identification in SCRIPT)
  • v2:RXE-13-Ordering Provider's DEA Number / RXO-14-Ordering Provider's DEA Number / RXE-14-Pharmacist/Treatment Supplier's Verifier ID / RXO-15-Pharmacist/Treatment Supplier's Verifier ID / ORC-12-Ordering Provider / PRT-5-Participation Person: PRT-4-Participation='OP' (all but last deprecated)
  • rim:.player
MedicationRequest.requester.onBehalfOf
DefinitionThe organization the device or practitioner was acting on behalf of.
Cardinality0...1
TypeReference(Organization)
SummaryTrue
Requirements

Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when authoring the request.

Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow:….onBehalfOf
  • rim:.scoper
MedicationRequest.recorder
DefinitionThe person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.
Cardinality0...1
TypeReference(Practitioner)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType)
  • w5:who
MedicationRequest.reasonCode
DefinitionThe reason or the indication for ordering the medication.
Cardinality0...*
TypeCodeableConcept
Binding

A coded concept indicating why the medication was ordered.

condition-code (example)
Comments

This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow:…reasonCode
  • script10.6:Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value
  • v2:ORC-16-Order Control Code Reason /RXE-27-Give Indication/RXO-20-Indication / RXD-21-Indication / RXG-22-Indication / RXA-19-Indication
  • rim:reason.observation.reasonCode
  • w5:why
MedicationRequest.reasonReference
DefinitionCondition or observation that supports why the medication was ordered.
Cardinality0...*
TypeReference(Condition | Observation)
Comments

This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow:…reasonReference
  • script10.6:no mapping
  • rim:reason.observation[code=ASSERTION].value
  • w5:why
MedicationRequest.note
DefinitionExtra information about the prescription that could not be conveyed by the other attributes.
Cardinality0...*
TypeAnnotation
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:N/A
  • rim:Act
  • workflow:…note
  • script10.6:Message/Body/NewRx/MedicationPrescribed/Note
  • rim:.inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value
MedicationRequest.dosageInstruction
DefinitionIndicates how the medication is to be used by the patient.
Cardinality0...*
TypeDosage
Comments

There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
  • workflow:…occurrence[x]
  • rim:see dosageInstruction mapping
MedicationRequest.dosageInstruction.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
MedicationRequest.dosageInstruction.sequence
DefinitionIndicates the order in which the dosage instructions should be applied or interpreted.
Cardinality0...1
Typeinteger
SummaryTrue
Requirements

If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.

Comments

32 bit number; for values larger than this, use decimal

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.text
MedicationRequest.dosageInstruction.text
DefinitionFree text dosage instructions e.g. SIG.
Cardinality0...1
Typestring
SummaryTrue
Requirements

Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing.

Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.text
MedicationRequest.dosageInstruction.additionalInstruction
DefinitionSupplemental instruction - e.g. "with meals".
Cardinality0...*
TypeCodeableConcept
Binding

A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

additional-instruction-codes (example)
SummaryTrue
Requirements

Additional instruction such as "Swallow with plenty of water" which may or may not be coded.

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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:.text
MedicationRequest.dosageInstruction.patientInstruction
DefinitionInstructions in terms that are understood by the patient or consumer.
Cardinality0...1
Typestring
SummaryTrue
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.text
MedicationRequest.dosageInstruction.timing
DefinitionWhen medication should be administered.
Cardinality0...1
TypeTiming
SummaryTrue
Requirements

The timing schedule for giving the medication to the patient. The Schedule data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

Comments

This attribute may not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:N/A
  • rim:QSET<TS> (GTS)
  • rim:.effectiveTime
MedicationRequest.dosageInstruction.asNeeded[x]
DefinitionIndicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).
Cardinality0...1
Typeboolean, CodeableConcept
Binding

A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

medication-as-needed-reason (example)
SummaryTrue
Comments

Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept
MedicationRequest.dosageInstruction.site
DefinitionBody site to administer to.
Cardinality0...1
TypeCodeableConcept
Binding

A coded concept describing the site location the medicine enters into or onto the body.

approach-site-codes (example)
SummaryTrue
Requirements

A coded specification of the anatomic site where the medication first enters the body.

Comments

If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension body-site-instance. May be a summary code, or a reference to a very precise definition of the location, or both.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:.approachSiteCode
MedicationRequest.dosageInstruction.route
DefinitionHow drug should enter body.
Cardinality0...1
TypeCodeableConcept
Binding

A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

route-codes (example)
SummaryTrue
Requirements

A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:.routeCode
MedicationRequest.dosageInstruction.method
DefinitionTechnique for administering medication.
Cardinality0...1
TypeCodeableConcept
Binding

A coded concept describing the technique by which the medicine is administered.

administration-method-codes (example)
SummaryTrue
Requirements

A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

Comments

Terminologies used often pre-coordinate this term with the route and or form of administration.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:.doseQuantity
MedicationRequest.dosageInstruction.dose[x]
DefinitionAmount of medication per dose.
Cardinality0...1
TypeRange, SimpleQuantity
SummaryTrue
Requirements

The amount of therapeutic or other substance given at one administration event.

Comments

Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.doseQuantity
MedicationRequest.dosageInstruction.maxDosePerPeriod
DefinitionUpper limit on medication per unit of time.
Cardinality0...1
TypeRatio
SummaryTrue
Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

Comments

This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • rat-1:Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present
    (numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())
Mappings
  • rim:n/a
  • v2:N/A
  • rim:RTO
  • rim:.maxDoseQuantity
MedicationRequest.dosageInstruction.maxDosePerAdministration
DefinitionUpper limit on medication per administration.
Cardinality0...1
TypeSimpleQuantity
SummaryTrue
Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

Comments

This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • qty-3:If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • sqty-1:The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • rim:n/a
  • v2:SN (see also Range) or CQ
  • rim:PQ, IVL<PQ>, MO, CO, depending on the values
  • rim:not supported
MedicationRequest.dosageInstruction.maxDosePerLifetime
DefinitionUpper limit on medication per lifetime of the patient.
Cardinality0...1
TypeSimpleQuantity
SummaryTrue
Requirements

The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • qty-3:If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • sqty-1:The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • rim:n/a
  • v2:SN (see also Range) or CQ
  • rim:PQ, IVL<PQ>, MO, CO, depending on the values
  • rim:not supported
MedicationRequest.dosageInstruction.rate[x]
DefinitionCantidad de medicamento por cantidad de tiempo.
Cardinality0...1
TypeSimpleQuantity, Ratio_apimin_v3
SummaryTrue
Requirements

Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

Comments

It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.rateQuantity
MedicationRequest.dispenseRequest
DefinitionIndicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.
Cardinality0...1
TypeBackboneElement
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • script10.6:Message/Body/NewRx/MedicationPrescribed/ExpirationDate
  • rim:component.supplyEvent
MedicationRequest.dispenseRequest.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
MedicationRequest.dispenseRequest.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
MedicationRequest.dispenseRequest.validityPeriod
DefinitionThis indicates the validity period of a prescription (stale dating the Prescription).
Cardinality0...1
TypePeriod
Requirements

Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription.

Comments

It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • per-1:If present, start SHALL have a lower value than end
    start.empty() or end.empty() or (start <= end)
Mappings
  • rim:n/a
  • v2:DR
  • rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • script10.6:Message/Body/NewRx/MedicationPrescribed/Refills
  • rim:effectiveTime
MedicationRequest.dispenseRequest.validityPeriod.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
MedicationRequest.dispenseRequest.validityPeriod.start
DefinitionThe start of the period. The boundary is inclusive.
Cardinality0...1
TypedateTime
SummaryTrue
Comments

If the low element is missing, the meaning is that the low boundary is not known.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:DR.1
  • rim:./low
MedicationRequest.dispenseRequest.validityPeriod.end
DefinitionFecha hasta que la receta se mantiene vigente, según la duración del tratamiento señalada en las prescripciones.
Cardinality0...1
TypedateTime
SummaryTrue
Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:DR.2
  • rim:./high
  • api-minsal:FEC_VIG_RECETA
MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
DefinitionNúmero de veces que la receta se debe despachar.
Cardinality0...1
TypepositiveInt
Comments

If displaying "number of authorized fills", add 1 to this number.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • script10.6:Message/Body/NewRx/MedicationPrescribed/Quantity
  • v2:RXE-12-Number of Refills
  • rim:repeatNumber
  • api-minsal:REPETICION_RECETA
MedicationRequest.dispenseRequest.quantity
DefinitionThe amount that is to be dispensed for one fill.
Cardinality0...1
TypeSimpleQuantity
Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • qty-3:If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • sqty-1:The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • rim:n/a
  • v2:SN (see also Range) or CQ
  • rim:PQ, IVL<PQ>, MO, CO, depending on the values
  • script10.6:Message/Body/NewRx/MedicationPrescribed/DaysSupply
  • v2:RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system
  • rim:quantity
MedicationRequest.dispenseRequest.expectedSupplyDuration
DefinitionIdentifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last.
Cardinality0...1
TypeDuration
Comments

In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage) When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • qty-3:If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • drt-1:There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
    code.exists() implies ((system = %ucum) and value.exists())
Mappings
  • rim:n/a
  • v2:SN (see also Range) or CQ
  • rim:PQ, IVL<PQ>, MO, CO, depending on the values
  • rim:PQ, IVL<PQ> depending on the values
  • script10.6:Message/Body/NewRx/MedicationPrescribed/Substitutions
  • rim:expectedUseTime
MedicationRequest.dispenseRequest.performer
DefinitionIndicates the intended dispensing Organization specified by the prescriber.
Cardinality0...1
TypeReference(Organization)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.outboundRelationship[typeCode=COMP].target[classCode=SPLY, moodCode=RQO] .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
  • w5:who
MedicationRequest.substitution
DefinitionIndicates whether or not substitution can or should be part of the dispense. In some cases substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done.
Cardinality0...1
TypeBackboneElement
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • script10.6:specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions
  • rim:subjectOf.substitutionPersmission
MedicationRequest.substitution.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
MedicationRequest.substitution.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
MedicationRequest.substitution.allowed
DefinitionTrue if the prescriber allows a different drug to be dispensed from what was prescribed.
Cardinality1...1
Typeboolean
ModifierTrue
Comments

This element is labeled as a modifer because whether substitution is allow or not cannot be ignored.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • script10.6:specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions
  • v2:RXO-9-Allow Substitutions / RXE-9-Substitution Status
  • rim:code
MedicationRequest.substitution.reason
DefinitionIndicates the reason for the substitution, or why substitution must or must not be performed.
Cardinality0...1
TypeCodeableConcept
Binding

A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.

HL7 v3 Value Set SubstanceAdminSubstitutionReason (example)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • script10.6:not mapped
  • v2:RXE-9 Substition status
  • rim:reasonCode
MedicationRequest.priorPrescription
DefinitionA link to a resource representing an earlier order related order or prescription.
Cardinality0...1
TypeReference(MedicationRequest)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow:…replaces
  • script10.6:not mapped
  • rim:.outboundRelationship[typeCode=?RPLC or ?SUCC]/target[classCode=SBADM,moodCode=RQO]
MedicationRequest.detectedIssue
DefinitionIndicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc.
Cardinality0...*
TypeReference(DetectedIssue)
AliasContraindication, Drug Utilization Review (DUR), Alert
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value
MedicationRequest.eventHistory
DefinitionLinks to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource.
Cardinality0...*
TypeReference(Provenance)
Comments

This may not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow:…relevantHistory
  • rim:.inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

Vacunas

Aquí se presentan todos los recursos que se utilizaron para mapear la información de las Vacunas.

  1. Definición de estructura para los datos de las Vacunas, aqui se definen principalmente los campos utilizados del recurso Immunization de HL7 FHIR. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/immunizationvacunasv3.

status
code
display
text
patientReference(Patient_apimin_v3)
date
locationReference(Location_apimin_v3)
lotNumber
doseQuantity
text
detailReference(Observation_apimin_v3)
series

  1. Definición de estructura para los datos del paciente. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/patientapiminv3.

system
valueS
birthDateS

  1. Definición de estructura para los datos del paciente. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/observationapiminv3.

system
code
text
valueQuantityQuantity
valueStringstring

  1. Definición de estructura para los datos del lugar el cual pertenece a la organización que relizó la vacuna. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/locationapiminv3.

system
value
name
text

Parámetros de Búsqueda Vacunas

Nombre Tipo Descripción Expresión Ejemplo
patient token Utilizado como el rut del paciente sin dígito verificador Immunization.patient patient.identifier=1111111
date date Fecha de la vacuna en formato YYYY-MM-DD Immunization.date date=2018-10-12 date=ge2018-10-12 date=lt2018-10-12
vaccine-code token Tipo de programa de Vacuna Immunization.vaccineCode vaccine-code=INTERNACIONAL

Prefijos implementados para búsquedas por fecha

Expresión Definición Ejemplo Significado
ge Mayor o Igual que ge2018-10-12 Resultados con fecha posterior o igual a 2018-10-12
lt Menor que lt2018-10-12 Resultados con fecha anterior a 2018-10-12

Referencia: Documentación completa en FHIR

Ejemplos de búsqueda

  • Búsqueda solo por rut
    GET [base]/Immunization?patient.identifer=23504868
    
  • Búsqueda por rut y rango de fechas
    GET [base]/Immunization?patient.identifer=23504868&date=ge2016-01-03&date=lt2018-01-03
    
  • Búsqueda por rut y tipo de vacunas
    GET [base]/Immunization?patient.identifer=23504868&vaccine-code=INTERNACIONAL
    
  • Búsqueda por rut, rango de fechas y tipo
    GET [base]/Immunization?patient.identifer=23504868&vaccine-code=INTERNACIONAL&date=ge2016-01-03&date=lt2018-01-03
    

Ejemplo de response

{
    "resourceType": "Bundle",
    "id": "819c58ce-44ff-475a-9a76-c9f0c59b35a2",
    "meta": {
        "lastUpdated": "2019-01-15T09:43:35.354-03:00"
    },
    "type": "searchset",
    "total": 2,
    "link": [
        {
            "relation": "self",
            "url": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/Immunization?patient.identifer=23504868&vaccine-code=INTERNACIONAL"
        }
    ],
    "entry": [
        {
            "fullUrl": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/Immunization/v242254420",
            "resource": {
                "resourceType": "Immunization",
                "id": "v242254420",
                "contained": [
                    {
                        "resourceType": "Patient",
                        "id": "p1",
                        "identifier": [
                            {
                                "system": "https://www.srcei.cl/RUT",
                                "value": "23504868"
                            }
                        ]
                    },
                    {
                        "resourceType": "Location",
                        "id": "l1",
                        "identifier": [
                            {
                                "system": "http://www.deis.cl",
                                "value": "9999"
                            }
                        ],
                        "name": "Clínica Alemana"
                    },
                    {
                        "resourceType": "Observation",
                        "id": "ob1",
                        "status": "registered",
                        "code": {
                            "text": "indeterminado"
                        },
                        "valueString": "SinReaccion"
                    }
                ],
                "status": "completed",
                "vaccineCode": {
                    "coding": [
                        {
                            "system": "https://vacunas.minsal.cl",
                            "display": "VACUNA FIEBRE AMARILLA"
                        }
                    ]
                },
                "patient": {
                    "reference": "#p1"
                },
                "date": "2016-01-05T00:00:00-03:00",
                "location": {
                    "reference": "#l1"
                },
                "lotNumber": "L5058-3",
                "doseQuantity": {
                    "code": "Única (0,5ml)"
                },
                "reaction": [
                    {
                        "detail": {
                            "reference": "#ob1"
                        }
                    }
                ],
                "vaccinationProtocol": [
                    {
                        "series": "INTERNACIONAL"
                    }
                ]
            }
        },
        {
            "fullUrl": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/Immunization/v242322222",
            "resource": {
                "resourceType": "Immunization",
                "id": "v242322222",
                "contained": [
                    {
                        "resourceType": "Patient",
                        "id": "p1",
                        "identifier": [
                            {
                                "system": "https://www.srcei.cl/RUT",
                                "value": "23504868"
                            }
                        ]
                    },
                    {
                        "resourceType": "Location",
                        "id": "l1",
                        "identifier": [
                            {
                                "system": "http://www.deis.cl",
                                "value": "9999"
                            }
                        ],
                        "name": "Clínica Alemana"
                    },
                    {
                        "resourceType": "Observation",
                        "id": "ob1",
                        "status": "registered",
                        "code": {
                            "text": "indeterminado"
                        },
                        "valueString": "SinReaccion"
                    }
                ],
                "status": "completed",
                "vaccineCode": {
                    "coding": [
                        {
                            "system": "https://vacunas.minsal.cl",
                            "display": "VACUNA FIEBRE AMARILLA"
                        }
                    ]
                },
                "patient": {
                    "reference": "#p1"
                },
                "date": "2016-01-05T00:00:00-03:00",
                "location": {
                    "reference": "#l1"
                },
                "lotNumber": "L5058-3",
                "doseQuantity": {
                    "code": "Única (0,5ml)"
                },
                "reaction": [
                    {
                        "detail": {
                            "reference": "#ob1"
                        }
                    }
                ],
                "vaccinationProtocol": [
                    {
                        "series": "INTERNACIONAL"
                    }
                ]
            }
        }
    ]
}

Dicccionario de Datos

Diccionario de Immunization

Immunization
DefinitionDescribes the event of a patient being administered a vaccination or a record of a vaccination as reported by a patient, a clinician or another party and may include vaccine reaction information and what vaccination protocol was followed.
Cardinality0...*
Invariants
  • dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-1:If the resource is contained in another resource, it SHALL NOT contain any narrative
    contained.text.empty()
  • dom-4:If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-3:If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
    contained.where(('#'+id in %resource.descendants().reference).not()).empty()
  • imm-2:If immunization was administered (notGiven=false) then explanation.reasonNotGiven SHALL be absent.
    (notGiven = true) or explanation.reasonNotGiven.empty()
  • imm-1:If immunization was not administered (notGiven=true) then there SHALL be no reaction nor explanation.reason present
    (notGiven = true).not() or (reaction.empty() and explanation.reason.empty())
Mappings
  • rim:Entity. Role, or Act
  • v2:VXU_V04
  • rim:SubstanceAdministration
  • w5:clinical.medication
Immunization.id
DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality0...1
Typeid
SummaryTrue
Comments

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

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

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

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

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

A human language.

languages (extensible)
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
Immunization.text
DefinitionA human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Cardinality0...1
TypeNarrative
Aliasnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
  • rim:Act.text?
Immunization.contained
DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Cardinality0...*
TypeResource
Aliasinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Immunization.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Immunization.identifier
DefinitionA unique identifier assigned to this immunization record.
Cardinality0...*
TypeIdentifier
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim:II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd:Identifier
  • workflow:Event.identifier
  • rim:.id
  • cda:ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/id
  • w5:id
Immunization.status
DefinitionIndicates the current status of the vaccination event.
Cardinality1...1
Typecode
Binding

A set of codes indicating the current status of an Immunization

immunization-status (required)
ModifierTrue
SummaryTrue
Comments

Will generally be set to show that the immunization has been completed.

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • workflow:Event.status
  • rim:statusCode
  • w5:status
  • api-minsal:tipo_fuente
Immunization.notGiven
DefinitionIndicates if the vaccination was or was not given.
Cardinality1...1
Typeboolean
ModifierTrue
SummaryTrue
Comments

This element is labeled as a modifier because it indicates that an immunization didn't happen.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • workflow:Event.notDone
  • rim:[actionNegationInd=true].reasonCode
  • w5:status
Immunization.vaccineCode
DefinitionVaccine that was administered or was to be administered.
Cardinality1...1
TypeCodeableConcept
Binding

The code for vaccine product administered

vaccine-code (example)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow:Event.code
  • v2:RXA-5
  • rim:.code
  • cda:ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/realmCode/code
  • w5:what
Immunization.vaccineCode.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Immunization.vaccineCode.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality0...*
TypeCoding
SummaryTrue
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE 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
Immunization.vaccineCode.coding.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Immunization.vaccineCode.coding.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality0...1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:C*E.3
  • rim:./codeSystem
  • orim:fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Immunization.vaccineCode.coding.version
DefinitionThe 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.
Cardinality0...1
Typestring
SummaryTrue
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:C*E.7
  • rim:./codeSystemVersion
  • orim:fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Immunization.vaccineCode.coding.code
DefinitionCódigo que representa un valor dentro de un sistema.
Cardinality0...1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:C*E.1
  • rim:./code
  • orim:fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  • api-minsal:TIPO
Immunization.vaccineCode.coding.display
DefinitionTexto explicativo del nombre de la vacuna.
Cardinality0...1
Typestring
SummaryTrue
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 may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:C*E.2 - but note this is not well followed
  • rim:CV.displayName
  • orim:fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
Immunization.vaccineCode.coding.userSelected
DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
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 ]
Immunization.vaccineCode.text
DefinitionA 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.
Cardinality0...1
Typestring
SummaryTrue
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
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
  • api-minsal:NOMBRE_VACUNA
Immunization.patient
DefinitionPaciente al cual se le aplicó la vacuna.
Cardinality1...1
TypeReference(Patient_apimin_v3)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow:Event.subject
  • v2:PID-3
  • rim:.partipication[ttypeCode=].role
  • w5:who.focus
Immunization.encounter
DefinitionThe visit or admission or other contact between patient and health care provider the immunization was performed as part of.
Cardinality0...1
TypeReference(Encounter)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow:Event.context
  • v2:PV1-19
  • rim:component->EncounterEvent
  • w5:context
Immunization.date
DefinitionFecha en la que se administro la vacuna.
Cardinality0...1
TypedateTime
Comments

When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known.  Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • workflow:Event.occurrence.occurrenceDateTime
  • v2:RXA-3
  • rim:.effectiveTime
  • cda:ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value
  • w5:when.init
  • api-minsal:FECHA_INMUNIZACION
Immunization.primarySource
DefinitionAn indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded.
Cardinality1...1
Typeboolean
Comments

Reflects the “reliability” of the content.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:RXA-9
  • rim:immunization.uncertaintycode (if primary source=false, uncertainty=U)
  • w5:who.source
Immunization.reportOrigin
DefinitionThe source of the data when the report of the immunization event is not based on information from the person who administered the vaccine.
Cardinality0...1
TypeCodeableConcept
Binding

The source of the data for a record which is not from a primary source.

immunization-origin (example)
Comments

Should not be populated if primarySource = True, will not be required even if primarySource = False.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:RXA-9
  • rim:.participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported) .participation[typeCode=INF].role[classCode=LIC] (this syntax for health care professional) .participation[typeCode=INF].role[classCode=PRS] (this syntax for family member)
  • w5:who.source
Immunization.location
DefinitionThe service delivery location where the vaccine administration occurred.
Cardinality0...1
TypeReference(Location_apimin_v3)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:RXA-27 (or RXA-11, deprecated as of v2.7)
  • rim:.participation[typeCode=LOC].COCT_MT240000UV
  • w5:where
Immunization.manufacturer
DefinitionName of vaccine manufacturer.
Cardinality0...1
TypeReference(Organization)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:RXA-17
  • rim:.participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=ORG]
  • cda:ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacuturerOrganization/name
Immunization.lotNumber
DefinitionNúmero del lote de la vacuna.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:RXA-15
  • rim:.participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].id
  • cda:ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/lotNumberText
  • api-minsal:LOTE
Immunization.expirationDate
DefinitionDate vaccine batch expires.
Cardinality0...1
Typedate
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:RXA-16
  • rim:.participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime
Immunization.site
DefinitionBody site where vaccine was administered.
Cardinality0...1
TypeCodeableConcept
Binding

The site at which the vaccine was administered

immunization-site (example)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:RXR-2
  • rim:observation.targetSiteCode
  • cda:ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/approachSiteCode/code
Immunization.route
DefinitionThe path by which the vaccine product is taken into the body.
Cardinality0...1
TypeCodeableConcept
Binding

The route by which the vaccine was administered

immunization-route (example)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:RXR-1
  • rim:.routeCode
  • cda:ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/routeCode/code
Immunization.doseQuantity
DefinitionLa cantidad de la vacuna que se administro.
Cardinality0...1
TypeSimpleQuantity
Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • qty-3:If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • sqty-1:The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • rim:n/a
  • v2:SN (see also Range) or CQ
  • rim:PQ, IVL<PQ>, MO, CO, depending on the values
  • v2:RXA-6 / RXA-7.1
  • rim:.doseQuantity
  • api-minsal:DOSIS
Immunization.practitioner
DefinitionIndicates who or what performed the event.
Cardinality0...*
TypeBackboneElement
SummaryTrue
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • workflow:Event.performer
  • v2:ORC-12 / RXA-10
  • rim:.participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
Immunization.practitioner.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Immunization.practitioner.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Immunization.practitioner.role
DefinitionDescribes the type of performance (e.g. ordering provider, administering provider, etc.).
Cardinality0...1
TypeCodeableConcept
Binding

The role a practitioner plays in the immunization event

immunization-role (extensible)
SummaryTrue
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow:Event.performer.role
  • rim:.participation.functionCode
Immunization.practitioner.actor
DefinitionThe device, practitioner, etc. who performed the action.
Cardinality1...1
TypeReference(Practitioner)
SummaryTrue
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow:Event.performer.actor
  • rim:.player
  • w5:who.actor
Immunization.note
DefinitionExtra information about the immunization that is not conveyed by the other attributes.
Cardinality0...*
TypeAnnotation
SummaryTrue
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:N/A
  • rim:Act
  • workflow:Event.note
  • rim:note
Immunization.explanation
DefinitionReasons why a vaccine was or was not administered.
Cardinality0...1
TypeBackboneElement
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
Immunization.explanation.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Immunization.explanation.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Immunization.explanation.reason
DefinitionRazón o Razones del porque se administro la vacuna.
Cardinality0...*
TypeCodeableConcept
Binding

The reason why a vaccine was administered

immunization-reason (example)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow:Event.reasonCodeableConcept
  • rim:[actionNegationInd=false].reasonCode
Immunization.explanation.reason.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Immunization.explanation.reason.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality0...*
TypeCoding
SummaryTrue
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE 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
Immunization.explanation.reason.text
DefinitionRazón porque se eligio la vacuna.
Cardinality0...1
Typestring
SummaryTrue
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
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
  • api-minsal:CRITERIO_ELEGIBILIDAD
Immunization.explanation.reasonNotGiven
DefinitionReason why a vaccine was not administered.
Cardinality0...*
TypeCodeableConcept
Binding

The reason why a vaccine was not administered

no-immunization-reason (example)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow:Event.notDoneReason
  • v2:RXA-18
  • rim:[actionNegationInd=true].reasonCode
Immunization.reaction
DefinitionCategorical data indicating that an adverse event is associated in time to an immunization.
Cardinality0...*
TypeBackboneElement
Comments

A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case, it should be recorded as a new AllergyIntolerance resource instance as most systems will not query against past Immunization.reaction elements.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:OBX-3
  • rim:Observation[classCode=obs].code
Immunization.reaction.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Immunization.reaction.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Immunization.reaction.date
DefinitionDate of reaction to the immunization.
Cardinality0...1
TypedateTime
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:OBX-14 (ideally this would be reported in an IAM segment, but IAM is not part of the HL7 v2 VXU message - most likely would appear in OBX segments if at all)
  • rim:.effectiveTime
Immunization.reaction.detail
DefinitionDetails of the reaction.
Cardinality0...1
TypeReference(Observation_apimin_v3)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:OBX-5
  • rim:.value
Immunization.reaction.reported
DefinitionSelf-reported indicator.
Cardinality0...1
Typeboolean
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:(no such concept seems to exist for allergy/adverse reaction in HL7 v2)
  • rim:.participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported=true)
Immunization.vaccinationProtocol
DefinitionContains information about the protocol(s) under which the vaccine was administered.
Cardinality0...*
TypeBackboneElement
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:(HL7 v2 doesn't seem to provide for this)
  • rim:outboundRelationship[typeCode=INST].target[classCode=SBADM]
Immunization.vaccinationProtocol.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Immunization.vaccinationProtocol.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Immunization.vaccinationProtocol.doseSequence
DefinitionNominal position in a series.
Cardinality0...1
TypepositiveInt
Comments

32 bit number; for values larger than this, use decimal

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:outboundRelationship[typeCode=INST].target[classCode=SBADM].inboundRelationship[typeCode=COMP].sequenceNumber
Immunization.vaccinationProtocol.description
DefinitionContains the description about the protocol under which the vaccine was administered.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:outboundRelationship[typeCode=INST].target[classCode=SBADM].inboundRelationship[typeCode=COMP].source[classCode=SBADM].text
Immunization.vaccinationProtocol.authority
DefinitionIndicates the authority who published the protocol. E.g. ACIP.
Cardinality0...1
TypeReference(Organization)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:outboundRelationship[typeCode=INST].target[classCode=SBADM].inboundRelationship[typeCode=COMP].source[classCode=SBADM].participation[typeCode=AUT].COCT_MT090200UV
Immunization.vaccinationProtocol.series
DefinitionOne possible path to achieve presumed immunity against a disease - within the context of an authority.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:outboundRelationship[typeCode=INST].target[classCode=SBADM]
  • api-minsal:tipo
Immunization.vaccinationProtocol.seriesDoses
DefinitionThe recommended number of doses to achieve immunity.
Cardinality0...1
TypepositiveInt
Comments

32 bit number; for values larger than this, use decimal

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:outboundRelationship[typeCode=INST].target[classCode=SBADM].inboundRelationship[typeCode=COMP].source[classCode=SBADM].text
Immunization.vaccinationProtocol.targetDisease
DefinitionThe targeted disease.
Cardinality1...*
TypeCodeableConcept
Binding

The disease target of the vaccination protocol

vaccination-protocol-dose-target (example)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:outboundRelationship.target[classCode=OBS].code
Immunization.vaccinationProtocol.doseStatus
DefinitionIndicates if the immunization event should "count" against the protocol.
Cardinality1...1
TypeCodeableConcept
Binding

The status of the vaccination protocol (i.e. should this count)

vaccination-protocol-dose-status (example)
Comments

May need to differentiate between status declarations by a provider vs. a CDS engine.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:.participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].playedRole[classCode=INGR].scopedRole.scoper[classCode=MMAT].playedRole[classCode=HLTHCHRT].participation[typeCode=SBJ].observation[classCode=OBS].value
Immunization.vaccinationProtocol.doseStatusReason
DefinitionProvides an explanation as to why an immunization event should or should not count against the protocol.
Cardinality0...1
TypeCodeableConcept
Binding

The reason for the determining if a vaccination should count or why vaccination should not count.

vaccination-protocol-dose-status-reason (example)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:.participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].playedRole[classCode=INGR].scopedRole.scoper[classCode=MMAT].playedRole[classCode=HLTHCHRT].participation[typeCode=SBJ].observation[classCode=OBS].reasonCode

Nacimientos

Aquí se presentan todos los recursos que se utilizaron para mapear la información de los Nacimientos.

  1. Definición de estructura para los datos de los Nacimientos, aqui se definen principalmente los campos utilizados del recurso Procedure de HL7 FHIR. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/procedurenacimientosv3.

status
subjectReference(Patient | Group_apimin_v3)
text
locationReference(Location_apimin_v3)
reasonReferenceReference(Condition | Observation_apimin_v3)
text

  1. Definición de estructura para los datos de los pacientes en un nacimiento (Hijo y Madre). También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/groupapiminv3.

entityReference(Patient | Patient_apimin_v3)

  1. Definición de estructura para los datos del paciente. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/patientapiminv3.

system
valueS
birthDateS

  1. Definición de estructura para los datos de las observaciones dentro del parto. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/observationapiminv3.

system
code
text
valueQuantityQuantity
valueStringstring

  1. Definición de estructura para los datos del lugar del nacimiento. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/locationapiminv3.

system
value
name
text

  1. Definición de estructura para los datos del establecimiento. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/organizationapimin.

systemS
valueS
nameS

Parámetros de Búsqueda Nacimientos

Nombre Tipo Descripción Expresión Ejemplo
subject token Utilizado como el rut del paciente sin dígito verificador Procedure.subject(Group) subject:Group.member.identifier=1111111
_profile token Utilizado como parametro identificador de esquema de datos por minsal _profile _profile=_profile=http://cens.cl/fhir/StructureDefinition/hospitaldigital-nacimientos
date date Fecha de nacimiento del hijo en formato YYYY-MM-DD patient.birthDate date=ge2018-10-12
date=lt2018-10-12
date=2018-10-12

Prefijos implementados para búsquedas por fecha

Expresión Definición Ejemplo Significado
ge Mayor o Igual que ge2018-10-12 Resultados con fecha posterior o igual a 2018-10-12
lt Menor que lt2018-10-12 Resultados con fecha anterior a 2018-10-12

Referencia: Documentación completa en FHIR

Ejemplos de búsqueda

  • Búsqueda solo por rut
    GET [base]/Procedure?subject:Group.member.identifier=25231520&_profile=http://cens.cl/fhir/StructureDefinition/hospitaldigital-nacimientos
    
  • Búsqueda por rut y rango de fechas
    GET [base]/Procedure?subject:Group.member.identifier=25231520&_profile=http://cens.cl/fhir/StructureDefinition/hospitaldigital-nacimientos&date=ge2015-01-12&date=lt2018-01-03
    

Ejemplo de response

{
    "resourceType": "Bundle",
    "id": "05fc9c01-d144-492c-8bbe-8b9a81453c12",
    "meta": {
        "lastUpdated": "2019-01-15T09:59:53.206-03:00"
    },
    "type": "searchset",
    "total": 1,
    "link": [
        {
            "relation": "self",
            "url": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/Procedure?_profile=http%3A%2F%2Fcens.cl%2Ffhir%2FStructureDefinition%2Fhospitaldigital-nacimientos&date=ge2015-01-12&date=lt2018-01-03&subject%3AGroup.member.identifier=25231520"
        }
    ],
    "entry": [
        {
            "fullUrl": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/Procedure/9884373",
            "resource": {
                "resourceType": "Procedure",
                "id": "9884373",
                "contained": [
                    {
                        "resourceType": "Patient",
                        "id": "p1",
                        "identifier": [
                            {
                                "system": "https://www.srcei.cl/RUT",
                                "value": "15922059"
                            }
                        ]
                    },
                    {
                        "resourceType": "Patient",
                        "id": "p2",
                        "identifier": [
                            {
                                "system": "https://www.srcei.cl/RUT",
                                "value": "25231520"
                            }
                        ],
                        "birthDate": "2015-12-21"
                    },
                    {
                        "resourceType": "Group",
                        "id": "g1",
                        "member": [
                            {
                                "entity": {
                                    "reference": "#p1",
                                    "display": "madre"
                                }
                            },
                            {
                                "entity": {
                                    "reference": "#p2",
                                    "display": "hijo"
                                }
                            }
                        ]
                    },
                    {
                        "resourceType": "Location",
                        "id": "l1",
                        "name": "CLINICA ISAMEDICA",
                        "type": {
                            "text": "Hospital"
                        }
                    },
                    {
                        "resourceType": "Observation",
                        "id": "ob1",
                        "category": [
                            {
                                "coding": [
                                    {
                                        "system": "http://hl7.org/fhir/observation-category",
                                        "code": "vital-signs"
                                    }
                                ]
                            }
                        ],
                        "code": {
                            "text": "semanas"
                        },
                        "valueQuantity": {
                            "value": 40,
                            "unit": "semanas"
                        }
                    },
                    {
                        "resourceType": "Observation",
                        "id": "ob2",
                        "category": [
                            {
                                "coding": [
                                    {
                                        "system": "http://hl7.org/fhir/observation-category",
                                        "code": "procedure"
                                    }
                                ]
                            }
                        ],
                        "code": {
                            "text": "peso"
                        },
                        "valueQuantity": {
                            "value": 4090,
                            "unit": "kg"
                        }
                    },
                    {
                        "resourceType": "Observation",
                        "id": "ob3",
                        "category": [
                            {
                                "coding": [
                                    {
                                        "system": "http://hl7.org/fhir/observation-category",
                                        "code": "procedure"
                                    }
                                ]
                            }
                        ],
                        "code": {
                            "text": "talla"
                        },
                        "valueQuantity": {
                            "value": 50,
                            "unit": "cm"
                        }
                    },
                    {
                        "resourceType": "Observation",
                        "id": "ob4",
                        "category": [
                            {
                                "coding": [
                                    {
                                        "system": "http://hl7.org/fhir/observation-category",
                                        "code": "social-history"
                                    }
                                ]
                            }
                        ],
                        "code": {
                            "text": "hijos-vivos"
                        },
                        "valueQuantity": {
                            "value": 1,
                            "unit": "hijos"
                        }
                    },
                    {
                        "resourceType": "Observation",
                        "id": "ob5",
                        "category": [
                            {
                                "coding": [
                                    {
                                        "system": "http://hl7.org/fhir/observation-category",
                                        "code": "social-history"
                                    }
                                ]
                            }
                        ],
                        "code": {
                            "text": "hijos-fallecidos"
                        },
                        "valueQuantity": {
                            "value": 0,
                            "unit": "hijos"
                        }
                    },
                    {
                        "resourceType": "Observation",
                        "id": "ob6",
                        "category": [
                            {
                                "coding": [
                                    {
                                        "system": "http://hl7.org/fhir/observation-category",
                                        "code": "social-history"
                                    }
                                ]
                            }
                        ],
                        "code": {
                            "text": "hijos-total"
                        },
                        "valueQuantity": {
                            "value": 1,
                            "unit": "hijos"
                        }
                    },
                    {
                        "resourceType": "Observation",
                        "id": "ob7",
                        "category": [
                            {
                                "coding": [
                                    {
                                        "system": "http://hl7.org/fhir/observation-category",
                                        "code": "social-history"
                                    }
                                ]
                            }
                        ],
                        "code": {
                            "text": "edad"
                        },
                        "valueQuantity": {
                            "value": 27,
                            "unit": "años"
                        }
                    }
                ],
                "status": "completed",
                "subject": {
                    "reference": "#g1"
                },
                "performer": [
                    {
                        "role": {
                            "text": "Matrona"
                        }
                    }
                ],
                "location": {
                    "reference": "#l1",
                    "display": "Lugar del Parto"
                },
                "reasonReference": [
                    {
                        "reference": "#ob1"
                    },
                    {
                        "reference": "#ob2"
                    },
                    {
                        "reference": "#ob3"
                    },
                    {
                        "reference": "#ob4"
                    },
                    {
                        "reference": "#ob5"
                    },
                    {
                        "reference": "#ob6"
                    },
                    {
                        "reference": "#ob7"
                    }
                ],
                "outcome": {
                    "text": "Simple"
                }
            }
        }
    ]
}

Dicccionario de Datos

Diccionario de Procedure

Procedure
DefinitionAn action that is or was performed on a patient. This can be a physical intervention like an operation, or less invasive like counseling or hypnotherapy.
Cardinality0...*
Invariants
  • dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-1:If the resource is contained in another resource, it SHALL NOT contain any narrative
    contained.text.empty()
  • dom-4:If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-3:If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
    contained.where(('#'+id in %resource.descendants().reference).not()).empty()
  • pro-1:Reason not done is only permitted if notDone indicator is true
    notDoneReason.empty() or notDone = true
Mappings
  • rim:Entity. Role, or Act
  • rim:Procedure[moodCode=EVN]
  • w5:clinical.general
Procedure.id
DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality0...1
Typeid
SummaryTrue
Comments

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

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

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

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

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

A human language.

languages (extensible)
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
Procedure.text
DefinitionA human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Cardinality0...1
TypeNarrative
Aliasnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
  • rim:Act.text?
Procedure.contained
DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Cardinality0...*
TypeResource
Aliasinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Procedure.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Procedure.identifier
DefinitionThis records identifiers associated with this procedure that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).
Cardinality0...*
TypeIdentifier
SummaryTrue
Requirements

Need to allow connection to a wider workflow.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim:II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd:Identifier
  • v2:Some combination of ORC-2 / ORC-3 / OBR-2 / OBR-3 / IPC-1 / IPC-2 / IPC-3 / IPC-4
  • rim:.id
  • w5:id
Procedure.definition
DefinitionA protocol, guideline, orderset or other definition that was adhered to in whole or in part by this procedure.
Cardinality0...*
TypeReference(PlanDefinition | ActivityDefinition | HealthcareService)
SummaryTrue
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.outboundRelationship[typeCode=DEFN].target
Procedure.basedOn
DefinitionA reference to a resource that contains details of the request for this procedure.
Cardinality0...*
TypeReference(CarePlan | ProcedureRequest | ReferralRequest)
SummaryTrue
Aliasfulfills
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.outboundRelationship[typeCode=FLFS].target[classCode=(various e.g. PROC, OBS, PCPR, ACT, moodCode=RQO].code
Procedure.partOf
DefinitionA larger event of which this particular procedure is a component or step.
Cardinality0...*
TypeReference(Procedure | Observation | MedicationAdministration)
SummaryTrue
Aliascontainer
Comments

The MedicationAdministration has a partOf reference to Procedure, but this is not a circular reference. For a surgical procedure, the anesthesia related medicationAdministration is part of the procedure. For an IV medication administration, the procedure to insert the IV port is part of the medication administration.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.inboundRelationship[typeCode=COMP].source[classCode=SBADM or PROC or OBS, moodCode=EVN]
Procedure.status
DefinitionA code specifying the state of the procedure. Generally this will be in-progress or completed state.
Cardinality1...1
Typecode
Binding

A code specifying the state of the procedure.

event-status (required)
ModifierTrue
SummaryTrue
Comments

The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure.

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:statusCode
  • w5:status
  • api-minsal:tipo_fuente
Procedure.notDone
DefinitionSet this to true if the record is saying that the procedure was NOT performed.
Cardinality0...1
Typeboolean
ModifierTrue
SummaryTrue
Comments

If true, it means the procedure did not occur as described. Typically it would be accompanied by attributes describing the type of activity. It might also be accompanied by body site information or time information (i.e. no procedure was done to the left arm or no procedure was done in this 2-year period). Specifying additional information such as performer, outcome, etc. is generally inappropriate. For example, it's not that useful to say "There was no appendectomy done at 12:03pm June 6th by Dr. Smith with a successful outcome" as it implies that there could have been an appendectomy done at any other time, by any other clinician or with any other outcome.

This element is labeled as a modifier because it indicates that a procedure didn't happen.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.actionNegationInd
Procedure.notDoneReason
DefinitionA code indicating why the procedure was not performed.
Cardinality0...1
TypeCodeableConcept
Binding

A code that identifies the reason a procedure was not performed.

procedure-not-performed-reason (example)
SummaryTrue
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:.reason.Observation.value
Procedure.category
DefinitionA code that classifies the procedure for searching, sorting and display purposes (e.g. "Surgical Procedure").
Cardinality0...1
TypeCodeableConcept
Binding

A code that classifies a procedure for searching, sorting and display purposes.

procedure-category (example)
SummaryTrue
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:.outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
  • w5:class
Procedure.code
DefinitionThe specific procedure that is performed. Use text if the exact nature of the procedure cannot be coded (e.g. "Laparoscopic Appendectomy").
Cardinality0...1
TypeCodeableConcept
Binding

A code to identify a specific procedure .

procedure-code (example)
SummaryTrue
Aliastype
Requirements

0..1 to account for primarily narrative only resources.

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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:OBR-44/OBR-45
  • rim:.code
  • w5:what
Procedure.subject
DefinitionThe person, animal or group on which the procedure was performed.
Cardinality1...1
TypeReference(Patient | Group_apimin_v3)
SummaryTrue
Aliaspatient
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:PID-3
  • rim:.participation[typeCode=SBJ].role
  • w5:who.focus
Procedure.context
DefinitionThe encounter during which the procedure was performed.
Cardinality0...1
TypeReference(Encounter | EpisodeOfCare)
SummaryTrue
Aliasencounter
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:PV1-19
  • rim:.inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
  • w5:context
Procedure.performed[x]
DefinitionThe date(time)/period over which the procedure was performed. Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be captured.
Cardinality0...1
TypedateTime, Period
SummaryTrue
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:OBR-7
  • rim:.effectiveTime
  • w5:when.done
Procedure.performer
DefinitionLimited to 'real' people rather than equipment.
Cardinality0...*
TypeBackboneElement
SummaryTrue
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.participation[typeCode=PRF]
Procedure.performer.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Procedure.performer.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Procedure.performer.role
DefinitionFor example: surgeon, anaethetist, endoscopist.
Cardinality0...1
TypeCodeableConcept
Binding

A code that identifies the role of a performer of the procedure.

performer-role (example)
SummaryTrue
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:Some combination of STF-18 / PRA-3 / PRT-4 / ROL-3 / ORC-12 / OBR-16 / PV1-7 / PV1-8 / PV1-9 / PV1-17 / OBX-25
  • rim:.functionCode
Procedure.performer.role.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Procedure.performer.role.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality0...*
TypeCoding
SummaryTrue
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE 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
Procedure.performer.role.text
DefinitionA 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.
Cardinality0...1
Typestring
SummaryTrue
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
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
  • api-minsal:tipo_atenc
Procedure.performer.actor
DefinitionThe practitioner who was involved in the procedure.
Cardinality1...1
TypeReference(Practitioner | Organization | Patient | RelatedPerson | Device)
SummaryTrue
Requirements

A reference to Device supports use cases, such as pacemakers.

Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:ORC-19/PRT-5
  • rim:.role
  • w5:who.actor
Procedure.performer.onBehalfOf
DefinitionThe organization the device or practitioner was acting on behalf of.
Cardinality0...1
TypeReference(Organization)
Requirements

Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when performing the action.

Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.scoper
Procedure.location
DefinitionThe location where the procedure actually happened. E.g. a newborn at home, a tracheostomy at a restaurant.
Cardinality0...1
TypeReference(Location_apimin_v3)
SummaryTrue
Requirements

Ties a procedure to where the records are likely kept.

Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.participation[typeCode=LOC].role[classCode=SDLOC]
  • w5:where
Procedure.reasonCode
DefinitionThe coded reason why the procedure was performed. This may be coded entity of some type, or may simply be present as text.
Cardinality0...*
TypeCodeableConcept
Binding

A code that identifies the reason a procedure is required.

procedure-reason (example)
SummaryTrue
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:.reasonCode
  • w5:why
Procedure.reasonReference
DefinitionThe condition that is the reason why the procedure was performed.
Cardinality0...*
TypeReference(Condition | Observation_apimin_v3)
SummaryTrue
Comments

e.g. endoscopy for dilatation and biopsy, combination diagnosis and therapeutic.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.reasonCode
  • w5:why
Procedure.bodySite
DefinitionDetailed and structured anatomical location information. Multiple locations are allowed - e.g. multiple punch biopsies of a lesion.
Cardinality0...*
TypeCodeableConcept
Binding

Codes describing anatomical locations. May include laterality.

body-site (example)
SummaryTrue
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:OBX-20
  • rim:.targetSiteCode
Procedure.outcome
DefinitionThe outcome of the procedure - did it resolve reasons for the procedure being performed?
Cardinality0...1
TypeCodeableConcept
Binding

An outcome of a procedure - whether it was resolved or otherwise.

procedure-outcome (example)
SummaryTrue
Comments

If outcome contains narrative text only, it can be captured using the CodeableConcept.text.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:.outboundRelationship[typeCode=OUT].target.text
Procedure.outcome.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Procedure.outcome.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality0...*
TypeCoding
SummaryTrue
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE 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
Procedure.outcome.text
DefinitionA 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.
Cardinality0...1
Typestring
SummaryTrue
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
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
  • api-minsal:tipo_parto
Procedure.report
DefinitionThis could be a histology result, pathology report, surgical report, etc..
Cardinality0...*
TypeReference(DiagnosticReport)
Comments

There could potentially be multiple reports - e.g. if this was a procedure which took multiple biopsies resulting in a number of anatomical pathology reports.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN]
Procedure.complication
DefinitionAny complications that occurred during the procedure, or in the immediate post-performance period. These are generally tracked separately from the notes, which will typically describe the procedure itself rather than any 'post procedure' issues.
Cardinality0...*
TypeCodeableConcept
Binding

Codes describing complications that resulted from a procedure.

condition-code (example)
Comments

If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:.outboundRelationship[typeCode=OUTC].target[classCode=OBS, code="complication", moodCode=EVN].value
Procedure.complicationDetail
DefinitionAny complications that occurred during the procedure, or in the immediate post-performance period.
Cardinality0...*
TypeReference(Condition)
Requirements

This is used to document a condition that is a result of the procedure, not the condition that was the reason for the procedure.

Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.outboundRelationship[typeCode=OUTC].target[classCode=OBS, code="complication", moodCode=EVN].value
Procedure.followUp
DefinitionIf the procedure required specific follow up - e.g. removal of sutures. The followup may be represented as a simple note, or could potentially be more complex in which case the CarePlan resource can be used.
Cardinality0...*
TypeCodeableConcept
Binding

Specific follow up required for a procedure e.g. removal of sutures.

procedure-followup (example)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:.outboundRelationship[typeCode=COMP].target[classCode=ACT, moodCode=INT].code
Procedure.note
DefinitionAny other notes about the procedure. E.g. the operative notes.
Cardinality0...*
TypeAnnotation
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:N/A
  • rim:Act
  • v2:NTE
  • rim:.inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value
Procedure.focalDevice
DefinitionA device that is implanted, removed or otherwise manipulated (calibration, battery replacement, fitting a prosthesis, attaching a wound-vac, etc.) as a focal portion of the Procedure.
Cardinality0...*
TypeBackboneElement
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.participation[typeCode=DEV].role[classCode=MANU]
Procedure.focalDevice.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Procedure.focalDevice.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Procedure.focalDevice.action
DefinitionThe kind of change that happened to the device during the procedure.
Cardinality0...1
TypeCodeableConcept
Binding

A kind of change that happened to the device during the procedure.

device-action (preferred)
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:.inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="procedure device action"].value=:procedure device action codes
Procedure.focalDevice.manipulated
DefinitionThe device that was manipulated (changed) during the procedure.
Cardinality1...1
TypeReference(Device)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.participation[typeCode=DEV].role[classCode=SDLOC]
Procedure.usedReference
DefinitionIdentifies medications, devices and any other substance used as part of the procedure.
Cardinality0...*
TypeReference(Device | Medication | Substance)
Requirements

Used for tracking contamination, etc.

Comments

For devices actually implanted or removed, use Procedure.device.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.participation[typeCode=DEV].role[classCode=MANU] or .participation[typeCode=CSM].role[classCode=ADMM] (for Medication or Substance)
Procedure.usedCode
DefinitionIdentifies coded items that were used as part of the procedure.
Cardinality0...*
TypeCodeableConcept
Binding

Codes describing items used during a procedure

device-kind (example)
Comments

For devices actually implanted or removed, use Procedure.device.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:participation[typeCode=Dev].role[classCode=MANU]