UK Core Implementation Guide STU3 Sequence

Please note:

This version of the UK Core is for C&TA Sprint 7 Review.
This version is not suitable for implementation. Other versions are available on the UK Core Version History Guide
Please follow the guidance on the Contact Us page if you need any assistance.
A summary of changes is available on the STU3 Sequence Change Log

StructureDefinition Extension-UKCore-TriggeredBy

Canonical_URL	Description	Profile_Purpose
http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy	This extension supports the sharing of the observation(s) that triggered the performance of the main observation.	This is a Pathology use case to backport R5 functionality to identify the observation(s) that triggered the performance of this observation.

Context of Use

Observation

Tree View

Extension	I		Extension	Element Id Extension Short description Triggering observation(s) Definition Identifies the observation(s) that triggered the performance of this observation. Data Type Extension Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
extension	I	2..*	Extension	Element Id Extension.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
observation	I	1..1	Extension	Element Id Extension.extension:observation Short description Triggering observation Alternate names extensions, user content Definition Reference to the triggering observation. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	Element Id Extension.extension:observation.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value observation Mappings rim:N/A
value[x]		1..1		There are no (further) constraints on this element Element Id Extension.extension:observation.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A
valueReference			Reference(UK Core Observation)	Data Type Reference(UK Core Observation)
type	I	1..1	ExtensionBinding	Element Id Extension.extension:type Short description reflex \| repeat \| re-run Alternate names extensions, user content Definition The type of trigger. Reflex \| Repeat \| Re-run. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Binding http://hl7.org/fhir/ValueSet/observation-triggeredbytype (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	Element Id Extension.extension:type.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value type Mappings rim:N/A
value[x]		1..1		There are no (further) constraints on this element Element Id Extension.extension:type.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A
valueCode			code	Data Type code
reason	I	0..1	Extension	Element Id Extension.extension:reason Short description Reason that the observation was triggered Alternate names extensions, user content Definition Provides the reason why this observation was performed as a result of the observation(s) referenced. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	Element Id Extension.extension:reason.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value reason Mappings rim:N/A
value[x]		1..1		There are no (further) constraints on this element Element Id Extension.extension:reason.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A
valueString			string	Data Type string
url		1..1	System.StringFixed Value	Element Id Extension.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy Mappings rim:N/A
value[x]		0..0		There are no (further) constraints on this element Element Id Extension.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A

Table View

Extension		..
Extension.extension		2..
Extension.extension		1..1
Extension.extension.url		..
Extension.extension.value[x]	Reference(UK Core Observation)	1..
Extension.extension		1..1
Extension.extension.url		..
Extension.extension.value[x]	code	1..
Extension.extension		0..1
Extension.extension.url		..
Extension.extension.value[x]	string	1..
Extension.url		..
Extension.value[x]		..0

XML View

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="Extension-UKCore-TriggeredBy" />
    <url value="http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy" />
    <version value="1.0" />
    <name value="ExtensionUKCoreTriggeredBy" />
    <title value="Extension UK Core Triggered By" />
    <status value="active" />
    <date value="2023-04-28" />
    <publisher value="HL7 UK" />
    <contact>
        <name value="HL7 UK" />
        <telecom>
            <system value="email" />
            <value value="ukcore@hl7.org.uk" />
            <use value="work" />
            <rank value="1" />
        </telecom>
    </contact>
    <description value="This extension supports the sharing of the observation(s) that triggered the performance of the main observation." />
    <purpose value="This is a Pathology use case to backport R5 functionality to identify the observation(s) that triggered the performance of this observation." />
    <copyright value="Copyright &#169; 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the &quot;License&quot;); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an &quot;AS IS&quot; BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7&#174; FHIR&#174; standard Copyright &#169; 2011+ HL7 The HL7&#174; FHIR&#174; standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html." />
    <fhirVersion value="4.0.1" />
    <mapping>
        <identity value="rim" />
        <uri value="http://hl7.org/v3" />
        <name value="RIM Mapping" />
    </mapping>
    <kind value="complex-type" />
    <abstract value="false" />
    <context>
        <type value="element" />
        <expression value="Observation" />
    </context>
    <type value="Extension" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
    <derivation value="constraint" />
    <differential>
        <element id="Extension">
            <path value="Extension" />
            <short value="Triggering observation(s)" />
            <definition value="Identifies the observation(s) that triggered the performance of this observation." />
        </element>
        <element id="Extension.extension">
            <path value="Extension.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <rules value="open" />
            </slicing>
            <min value="2" />
        </element>
        <element id="Extension.extension:observation">
            <path value="Extension.extension" />
            <sliceName value="observation" />
            <short value="Triggering observation" />
            <definition value="Reference to the triggering observation." />
            <min value="1" />
            <max value="1" />
        </element>
        <element id="Extension.extension:observation.url">
            <path value="Extension.extension.url" />
            <fixedUri value="observation" />
        </element>
        <element id="Extension.extension:observation.value[x]">
            <path value="Extension.extension.value[x]" />
            <min value="1" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation" />
            </type>
        </element>
        <element id="Extension.extension:type">
            <path value="Extension.extension" />
            <sliceName value="type" />
            <short value="reflex | repeat | re-run" />
            <definition value="The type of trigger. Reflex | Repeat | Re-run." />
            <min value="1" />
            <max value="1" />
            <binding>
                <strength value="required" />
                <valueSet value="http://hl7.org/fhir/ValueSet/observation-triggeredbytype" />
            </binding>
        </element>
        <element id="Extension.extension:type.url">
            <path value="Extension.extension.url" />
            <fixedUri value="type" />
        </element>
        <element id="Extension.extension:type.value[x]">
            <path value="Extension.extension.value[x]" />
            <min value="1" />
            <type>
                <code value="code" />
            </type>
        </element>
        <element id="Extension.extension:reason">
            <path value="Extension.extension" />
            <sliceName value="reason" />
            <short value="Reason that the observation was triggered" />
            <definition value="Provides the reason why this observation was performed as a result of the observation(s) referenced." />
            <min value="0" />
            <max value="1" />
        </element>
        <element id="Extension.extension:reason.url">
            <path value="Extension.extension.url" />
            <fixedUri value="reason" />
        </element>
        <element id="Extension.extension:reason.value[x]">
            <path value="Extension.extension.value[x]" />
            <min value="1" />
            <type>
                <code value="string" />
            </type>
        </element>
        <element id="Extension.url">
            <path value="Extension.url" />
            <fixedUri value="http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy" />
        </element>
        <element id="Extension.value[x]">
            <path value="Extension.value[x]" />
            <max value="0" />
        </element>
    </differential>
</StructureDefinition>

JSON View

{
    "resourceType": "StructureDefinition",
    "id": "Extension-UKCore-TriggeredBy",
    "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy",
    "version": "1.0",
    "name": "ExtensionUKCoreTriggeredBy",
    "title": "Extension UK Core Triggered By",
    "status": "active",
    "date": "2023-04-28",
    "publisher": "HL7 UK",
    "contact":  [
        {
            "name": "HL7 UK",
            "telecom":  [
                {
                    "system": "email",
                    "value": "ukcore@hl7.org.uk",
                    "use": "work",
                    "rank": 1
                }
            ]
        }
    ],
    "description": "This extension supports the sharing of the observation(s) that triggered the performance of the main observation.",
    "purpose": "This is a Pathology use case to backport R5 functionality to identify the observation(s) that triggered the performance of this observation.",
    "copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html.",
    "fhirVersion": "4.0.1",
    "mapping":  [
        {
            "identity": "rim",
            "uri": "http://hl7.org/v3",
            "name": "RIM Mapping"
        }
    ],
    "kind": "complex-type",
    "abstract": false,
    "context":  [
        {
            "type": "element",
            "expression": "Observation"
        }
    ],
    "type": "Extension",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Extension",
                "path": "Extension",
                "short": "Triggering observation(s)",
                "definition": "Identifies the observation(s) that triggered the performance of this observation."
            },
            {
                "id": "Extension.extension",
                "path": "Extension.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "rules": "open"
                },
                "min": 2
            },
            {
                "id": "Extension.extension:observation",
                "path": "Extension.extension",
                "sliceName": "observation",
                "short": "Triggering observation",
                "definition": "Reference to the triggering observation.",
                "min": 1,
                "max": "1"
            },
            {
                "id": "Extension.extension:observation.url",
                "path": "Extension.extension.url",
                "fixedUri": "observation"
            },
            {
                "id": "Extension.extension:observation.value[x]",
                "path": "Extension.extension.value[x]",
                "min": 1,
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation"
                        ]
                    }
                ]
            },
            {
                "id": "Extension.extension:type",
                "path": "Extension.extension",
                "sliceName": "type",
                "short": "reflex | repeat | re-run",
                "definition": "The type of trigger. Reflex | Repeat | Re-run.",
                "min": 1,
                "max": "1",
                "binding": {
                    "strength": "required",
                    "valueSet": "http://hl7.org/fhir/ValueSet/observation-triggeredbytype"
                }
            },
            {
                "id": "Extension.extension:type.url",
                "path": "Extension.extension.url",
                "fixedUri": "type"
            },
            {
                "id": "Extension.extension:type.value[x]",
                "path": "Extension.extension.value[x]",
                "min": 1,
                "type":  [
                    {
                        "code": "code"
                    }
                ]
            },
            {
                "id": "Extension.extension:reason",
                "path": "Extension.extension",
                "sliceName": "reason",
                "short": "Reason that the observation was triggered",
                "definition": "Provides the reason why this observation was performed as a result of the observation(s) referenced.",
                "min": 0,
                "max": "1"
            },
            {
                "id": "Extension.extension:reason.url",
                "path": "Extension.extension.url",
                "fixedUri": "reason"
            },
            {
                "id": "Extension.extension:reason.value[x]",
                "path": "Extension.extension.value[x]",
                "min": 1,
                "type":  [
                    {
                        "code": "string"
                    }
                ]
            },
            {
                "id": "Extension.url",
                "path": "Extension.url",
                "fixedUri": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"
            },
            {
                "id": "Extension.value[x]",
                "path": "Extension.value[x]",
                "max": "0"
            }
        ]
    }
}

Examples

Triggered By Drug Use - An example to illustrate the pre-adopted R5 element via an extension, which is used to indicate a triggering observation.
Example UKCore-Extension-TriggeredBy