<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="RiskAssessment" />
  <meta>
    <lastUpdated value="2021-01-02T08:58:31.578+11:00" />
  </meta>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-category">
    <valueString value="Clinical.Care Provision" />
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="trial-use" />
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="1" />
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category">
    <valueCode value="patient" />
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="cds" />
  </extension>
  <extension url="http://hl7.org/fhir/build/StructureDefinition/entered-in-error-status">
    <valueCode value=".status = entered-in-error" />
  </extension>
  <url value="http://hl7.org/fhir/StructureDefinition/RiskAssessment" />
  <version value="4.6.0" />
  <name value="RiskAssessment" />
  <status value="draft" />
  <date value="2021-01-02T08:58:31+11:00" />
  <publisher value="Health Level Seven International (Clinical Decision Support)" />
  <contact>
    <telecom>
      <system value="url" />
      <value value="http://hl7.org/fhir" />
    </telecom>
  </contact>
  <contact>
    <telecom>
      <system value="url" />
      <value value="http://www.hl7.org/Special/committees/dss/index.cfm" />
    </telecom>
  </contact>
  <description value="An assessment of the likely outcome(s) for a patient or other subject as well as the likelihood of each outcome." />
  <fhirVersion value="4.6.0" />
  <mapping>
    <identity value="workflow" />
    <uri value="http://hl7.org/fhir/workflow" />
    <name value="Workflow Pattern" />
  </mapping>
  <mapping>
    <identity value="v2" />
    <uri value="http://hl7.org/v2" />
    <name value="HL7 v2 Mapping" />
  </mapping>
  <mapping>
    <identity value="rim" />
    <uri value="http://hl7.org/v3" />
    <name value="RIM Mapping" />
  </mapping>
  <mapping>
    <identity value="openehr" />
    <uri value="http://openehr.org" />
    <name value="Open EHR Archetype Mapping" />
  </mapping>
  <mapping>
    <identity value="w5" />
    <uri value="http://hl7.org/fhir/fivews" />
    <name value="FiveWs Pattern Mapping" />
  </mapping>
  <kind value="resource" />
  <abstract value="false" />
  <type value="RiskAssessment" />
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
  <derivation value="specialization" />
  <differential>
    <element id="RiskAssessment">
      <path value="RiskAssessment" />
      <short value="Potential outcomes for a subject with likelihood" />
      <definition value="An assessment of the likely outcome(s) for a patient or other subject as well as the likelihood of each outcome." />
      <alias value="Prognosis" />
      <min value="0" />
      <max value="*" />
      <mapping>
        <identity value="workflow" />
        <map value="Event" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Observation[classCode=OBS, moodCode=EVN, code=&quot;Risk Assessment&quot;]" />
      </mapping>
      <mapping>
        <identity value="openehr" />
        <map value="OpenEHR-EHR-EVALUATION.risk.v1" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="clinical.general" />
      </mapping>
    </element>
    <element id="RiskAssessment.identifier">
      <path value="RiskAssessment.identifier" />
      <short value="Unique identifier for the assessment" />
      <definition value="Business identifier assigned to the risk assessment." />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="Identifier" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="workflow" />
        <map value="Event.identifier" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.identifier" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".id" />
      </mapping>
      <mapping>
        <identity value="openehr" />
        <map value="Workflow Identifier" />
      </mapping>
    </element>
    <element id="RiskAssessment.basedOn">
      <path value="RiskAssessment.basedOn" />
      <short value="Request fulfilled by this assessment" />
      <definition value="A reference to the request that is fulfilled by this risk assessment." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
      </type>
      <mapping>
        <identity value="workflow" />
        <map value="Event.basedOn" />
      </mapping>
    </element>
    <element id="RiskAssessment.parent">
      <path value="RiskAssessment.parent" />
      <short value="Part of this occurrence" />
      <definition value="A reference to a resource that this risk assessment is part of, such as a Procedure." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
      </type>
      <mapping>
        <identity value="workflow" />
        <map value="Event.partOf" />
      </mapping>
    </element>
    <element id="RiskAssessment.status">
      <path value="RiskAssessment.status" />
      <short value="registered | preliminary | final | amended +" />
      <definition value="The status of the RiskAssessment, using the same statuses as an Observation." />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="code" />
      </type>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="RiskAssessmentStatus" />
        </extension>
        <strength value="required" />
        <description value="The status of the risk assessment; e.g. preliminary, final, amended, etc." />
        <valueSet value="http://hl7.org/fhir/ValueSet/observation-status" />
      </binding>
      <mapping>
        <identity value="workflow" />
        <map value="Event.status" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.status" />
      </mapping>
    </element>
    <element id="RiskAssessment.method">
      <path value="RiskAssessment.method" />
      <short value="Evaluation mechanism" />
      <definition value="The algorithm, process or mechanism used to evaluate the risk." />
      <requirements value="The method can influence the results of the assessment." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="RiskAssessmentMethod" />
        </extension>
        <strength value="example" />
        <description value="The mechanism or algorithm used to make the assessment; e.g. TIMI, PRISM, Cardiff Type 2 diabetes, etc." />
      </binding>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.class" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".methodCode" />
      </mapping>
    </element>
    <element id="RiskAssessment.code">
      <path value="RiskAssessment.code" />
      <short value="Type of assessment" />
      <definition value="The type of the risk assessment performed." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="workflow" />
        <map value="Event.code" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.what[x]" />
      </mapping>
    </element>
    <element id="RiskAssessment.subject">
      <path value="RiskAssessment.subject" />
      <short value="Who/what does assessment apply to?" />
      <definition value="The patient or group the risk assessment applies to." />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="workflow" />
        <map value="Event.subject" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.subject[x]" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".participation[typeCode=SBJ].role" />
      </mapping>
      <mapping>
        <identity value="openehr" />
        <map value="Subject of Care" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.subject" />
      </mapping>
    </element>
    <element id="RiskAssessment.encounter">
      <path value="RiskAssessment.encounter" />
      <short value="Where was assessment performed?" />
      <definition value="The encounter where the assessment was performed." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="workflow" />
        <map value="Event.encounter" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.context" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]" />
      </mapping>
    </element>
    <element id="RiskAssessment.occurrence[x]">
      <path value="RiskAssessment.occurrence[x]" />
      <short value="When was assessment made?" />
      <definition value="The date (and possibly time) the risk assessment was performed." />
      <requirements value="The assessment results lose validity the more time elapses from when they are first made." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="dateTime" />
      </type>
      <type>
        <code value="Period" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="workflow" />
        <map value="Event.occurrence[x]" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.done[x]" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".effectiveTime" />
      </mapping>
    </element>
    <element id="RiskAssessment.condition">
      <path value="RiskAssessment.condition" />
      <short value="Condition assessed" />
      <definition value="For assessments or prognosis specific to a particular condition, indicates the condition being assessed." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Condition" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN]" />
      </mapping>
    </element>
    <element id="RiskAssessment.performer">
      <path value="RiskAssessment.performer" />
      <short value="Who did assessment?" />
      <definition value="The provider, patient, related person, or software application that performed the assessment." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="workflow" />
        <map value="Event.performer.actor" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.actor" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".participation[typeCode=PFM].role[classCode=ASSIGNED]" />
      </mapping>
      <mapping>
        <identity value="openehr" />
        <map value="Information Provider" />
      </mapping>
    </element>
    <element id="RiskAssessment.reason">
      <path value="RiskAssessment.reason" />
      <short value="Why the assessment was necessary?" />
      <definition value="The reason the risk assessment was performed." />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="CodeableReference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Condition" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference" />
      </type>
      <mapping>
        <identity value="workflow" />
        <map value="Event.reason" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.why[x]" />
      </mapping>
    </element>
    <element id="RiskAssessment.basis">
      <path value="RiskAssessment.basis" />
      <short value="Information used in assessment" />
      <definition value="Indicates the source data considered as part of the assessment (for example, FamilyHistory, Observations, Procedures, Conditions, etc.)." />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=DRIV].target" />
      </mapping>
      <mapping>
        <identity value="openehr" />
        <map value="Risk Factor; Link to Evidence" />
      </mapping>
    </element>
    <element id="RiskAssessment.prediction">
      <extension url="http://hl7.org/fhir/build/StructureDefinition/svg">
        <valueCode value="320,0" />
      </extension>
      <path value="RiskAssessment.prediction" />
      <short value="Outcome predicted" />
      <definition value="Describes the expected outcome for the subject." />
      <comment value="Multiple repetitions can be used to identify the same type of outcome in different timeframes as well as different types of outcomes." />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="BackboneElement" />
      </type>
      <constraint>
        <key value="ras-2" />
        <severity value="error" />
        <human value="Must be &lt;= 100" />
        <expression value="probability is decimal implies (probability as decimal) &lt;= 100" />
        <xpath value="not(f:probabilityDecimal) or f:probabilityDecimal/@value &lt;= 100" />
        <source value="http://hl7.org/fhir/StructureDefinition/RiskAssessment" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=VALUE].target[classCod=OBS, moodCode=RISK]" />
      </mapping>
    </element>
    <element id="RiskAssessment.prediction.outcome">
      <path value="RiskAssessment.prediction.outcome" />
      <short value="Possible outcome for the subject" />
      <definition value="One of the potential outcomes for the patient (e.g. remission, death,  a particular condition)." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="RiskAssessmentOutcome" />
        </extension>
        <strength value="example" />
        <description value="The condition or other outcome; e.g. death, remission, amputation, infection, etc." />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value=".value" />
      </mapping>
      <mapping>
        <identity value="openehr" />
        <map value="Risk" />
      </mapping>
    </element>
    <element id="RiskAssessment.prediction.probability[x]">
      <path value="RiskAssessment.prediction.probability[x]" />
      <short value="Likelihood of specified outcome" />
      <definition value="Indicates how likely the outcome is (in the specified timeframe)." />
      <comment value="If range is used, it represents the lower and upper bounds of certainty; e.g. 40-60%  Decimal values are expressed as percentages as well (max = 100)." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="decimal" />
      </type>
      <type>
        <code value="Range" />
      </type>
      <constraint>
        <key value="ras-1" />
        <severity value="error" />
        <human value="low and high must be percentages, if present" />
        <expression value="(low.empty() or ((low.code = '%') and (low.system = %ucum))) and (high.empty() or ((high.code = '%') and (high.system = %ucum)))" />
        <xpath value="(not(f:low) or f:low[f:code/@value='%' and f:system/@value='http://unitsofmeasure.org']) and (not(f:high) or f:high[f:code/@value='%' and f:system/@value='http://unitsofmeasure.org'])" />
        <source value="http://hl7.org/fhir/StructureDefinition/RiskAssessment" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;probability&quot;].value" />
      </mapping>
      <mapping>
        <identity value="openehr" />
        <map value="Category" />
      </mapping>
    </element>
    <element id="RiskAssessment.prediction.qualitativeRisk">
      <path value="RiskAssessment.prediction.qualitativeRisk" />
      <short value="Likelihood of specified outcome as a qualitative value" />
      <definition value="Indicates how likely the outcome is (in the specified timeframe), expressed as a qualitative value (e.g. low, medium, or high)." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="RiskAssessmentProbability" />
        </extension>
        <strength value="example" />
        <description value="The likelihood of the occurrence of a specified outcome." />
        <valueSet value="http://hl7.org/fhir/ValueSet/risk-probability" />
      </binding>
    </element>
    <element id="RiskAssessment.prediction.relativeRisk">
      <path value="RiskAssessment.prediction.relativeRisk" />
      <short value="Relative likelihood" />
      <definition value="Indicates the risk for this particular subject (with their specific characteristics) divided by the risk of the population in general.  (Numbers greater than 1 = higher risk than the population, numbers less than 1 = lower risk.)." />
      <requirements value="Absolute risk is less meaningful than relative risk." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="decimal" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;relative risk&quot;].value" />
      </mapping>
    </element>
    <element id="RiskAssessment.prediction.when[x]">
      <path value="RiskAssessment.prediction.when[x]" />
      <short value="Timeframe or age range" />
      <definition value="Indicates the period of time or age range of the subject to which the specified probability applies." />
      <comment value="If not specified, the risk applies &quot;over the subject's lifespan&quot;." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Period" />
      </type>
      <type>
        <code value="Range" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value=".effectiveTime or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;age&quot;].value" />
      </mapping>
    </element>
    <element id="RiskAssessment.prediction.rationale">
      <path value="RiskAssessment.prediction.rationale" />
      <short value="Explanation of prediction" />
      <definition value="Additional information explaining the basis for the prediction." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="string" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value=".reasonCode.text" />
      </mapping>
      <mapping>
        <identity value="openehr" />
        <map value="Rationale" />
      </mapping>
    </element>
    <element id="RiskAssessment.mitigation">
      <path value="RiskAssessment.mitigation" />
      <short value="How to reduce risk" />
      <definition value="A description of the steps that might be taken to reduce the identified risk(s)." />
      <requirements value="One of the main reasons for assessing risks is to identify whether interventional steps are needed to reduce risk." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="string" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=MTGT].target[classCode=ACT, moodCode=EVN].text" />
      </mapping>
    </element>
    <element id="RiskAssessment.note">
      <path value="RiskAssessment.note" />
      <short value="Comments on the risk assessment" />
      <definition value="Additional comments about the risk assessment." />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="Annotation" />
      </type>
      <mapping>
        <identity value="workflow" />
        <map value="Event.note" />
      </mapping>
    </element>
  </differential>
</StructureDefinition>