<status value="active" /> <experimental value="false" /> <date value="2025-04-30" /> <publisher value="Tiplu GmbH" /> <description value="Tiplu presumed diagnoses are generated and displayed based on a set of rules derived from medical guidelines and literature (state-of-the-art medicine). Customised presumptive diagnoses can be created and released to all MAIA users in the hospital by physicians trained by the manufacturer, known as Medical Administrators, using a rules editor built into MAIA. These function similarly to Tiplu presumed diagnoses, but additionally provide the option to include therapy and diagnostic information. Medical administrators can enable/disable these rules only for patients within the departments for which they have access rights. *German:* Tiplu-Verdachtsdiagnosen werden auf der Grundlage eines von Leitlinien und Fachliteratur (State-of-the-Art Medizin) basierenden Regelwerkes generiert und angezeigt. Vom Hersteller geschulte Ärzte, so genannte Medical Administrators, können mithilfe eines in MAIA integrierten Regeleditors benutzerdefinierte Verdachtsdiagnosen erstellen und für alle MAIA-Benutzer im Krankenhaus freigeben. Diese funktionieren analog zu Tiplu-Verdachtsdiagnosen, bieten jedoch zusätzlich die Möglichkeit, Therapie- und Diagnostikinformationen zu hinterlegen. Medizinische Administrator:innen können dabei entsprechende Hinweise nur für Patient:innen der Fachabteilungen aktivieren/deaktivieren, auf deren Patient:innen sie ein Zugriffsrecht haben." /> <fhirVersion value="4.0.1" /> <kind value="resource" /> <abstract value="false" /> <type value="RiskAssessment" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/RiskAssessment" /> <derivation value="constraint" /> <differential> <element id="RiskAssessment.text"> <path value="RiskAssessment.text" /> <short value="human-readable narrative" /> <comment value="HTML representation of this rule-based evaluation" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.text.status"> <path value="RiskAssessment.text.status" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.text.div"> <path value="RiskAssessment.text.div" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.extension"> <path value="RiskAssessment.extension" /> <min value="2" /> </element> <element id="RiskAssessment.extension:ReviewStatus"> <path value="RiskAssessment.extension" /> <sliceName value="ReviewStatus" /> <min value="1" /> <max value="1" /> <type> <code value="Extension" /> <profile value="https://tiplu.de/fhir/maia/StructureDefinition/MaiaRuleBasedEvaluationReviewStatus" /> </type> <mustSupport value="true" /> </element> <element id="RiskAssessment.extension:ReviewStatus.value[x]"> <path value="RiskAssessment.extension.value[x]" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.extension:DefinitionReference"> <path value="RiskAssessment.extension" /> <sliceName value="DefinitionReference" /> <min value="1" /> <max value="1" /> <type> <code value="Extension" /> <profile value="https://tiplu.de/fhir/maia/StructureDefinition/MaiaRiskAssessmentDefinitionReference" /> </type> <mustSupport value="true" /> </element> <element id="RiskAssessment.extension:DefinitionReference.value[x]"> <path value="RiskAssessment.extension.value[x]" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.modifierExtension:HiddenReason"> <path value="RiskAssessment.modifierExtension" /> <sliceName value="HiddenReason" /> <min value="0" /> <max value="1" /> <type> <code value="Extension" /> <profile value="https://tiplu.de/fhir/maia/StructureDefinition/MaiaHiddenReason" /> </type> <mustSupport value="true" /> </element> <element id="RiskAssessment.modifierExtension:HiddenReason.value[x]"> <path value="RiskAssessment.modifierExtension.value[x]" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.modifierExtension:HiddenReason.value[x].coding:Reason"> <path value="RiskAssessment.modifierExtension.value[x].coding" /> <sliceName value="Reason" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.modifierExtension:HiddenReason.value[x].coding:Reason.system"> <path value="RiskAssessment.modifierExtension.value[x].coding.system" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.modifierExtension:HiddenReason.value[x].coding:Reason.code"> <path value="RiskAssessment.modifierExtension.value[x].coding.code" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.modifierExtension:HiddenReason.value[x].coding:Reason.display"> <path value="RiskAssessment.modifierExtension.value[x].coding.display" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.modifierExtension:HiddenReason.value[x].text"> <path value="RiskAssessment.modifierExtension.value[x].text" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.parent"> <path value="RiskAssessment.parent" /> <type> <code value="Reference" /> <targetProfile value="https://tiplu.de/fhir/maia/StructureDefinition/MaiaRuleBasedEvaluation" /> </type> </element> <element id="RiskAssessment.status"> <path value="RiskAssessment.status" /> <short value="Status of the rule-based evaluation" /> <comment value="Status 'preliminary' is default set for rule-based evaluation." /> <mustSupport value="true" /> </element> <element id="RiskAssessment.method"> <path value="RiskAssessment.method" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.method.coding"> <path value="RiskAssessment.method.coding" /> <slicing> <discriminator> <type value="pattern" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> <min value="1" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.method.coding:AssessmentMethod"> <path value="RiskAssessment.method.coding" /> <sliceName value="AssessmentMethod" /> <short value="Assessment method used for this RiskAssessment" /> <min value="1" /> <max value="1" /> <patternCoding> <system value="https://tiplu.de/fhir/maia/CodeSystem/MaiaAssessmentMethod" /> </patternCoding> <mustSupport value="true" /> <binding> <strength value="required" /> <valueSet value="https://tiplu.de/fhir/maia/ValueSet/MaiaAssessmentMethodVS" /> </binding> </element> <element id="RiskAssessment.method.coding:AssessmentMethod.system"> <path value="RiskAssessment.method.coding.system" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.method.coding:AssessmentMethod.code"> <path value="RiskAssessment.method.coding.code" /> <min value="1" /> <patternCode value="TRBE" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.method.coding:AssessmentMethod.display"> <path value="RiskAssessment.method.coding.display" /> <min value="1" /> <patternString value="Tiplu rule-based evaluation" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.code"> <path value="RiskAssessment.code" /> <definition value="Code of the assessed rule-based evaluation" /> <min value="1" /> <constraint> <key value="MaiaTrbeCodeOrText" /> <severity value="error" /> <human value="A code from MaiaPresumedDiagnosisAssessmentType and a free-text display (code.text) must not be used at the same time." /> <expression value="coding.where(system = 'https://tiplu.de/fhir/maia/CodeSystem/MaiaPresumedDiagnosisAssessmentType').exists() xor text.exists()" /> <source value="https://tiplu.de/fhir/maia/StructureDefinition/MaiaRuleBasedEvaluation" /> </constraint> <mustSupport value="true" /> </element> <element id="RiskAssessment.code.coding"> <path value="RiskAssessment.code.coding" /> <slicing> <discriminator> <type value="pattern" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> <mustSupport value="true" /> </element> <element id="RiskAssessment.code.coding:AssessmentType"> <path value="RiskAssessment.code.coding" /> <sliceName value="AssessmentType" /> <short value="Coding of the Tiplu presumed diagnosis" /> <min value="0" /> <max value="1" /> <mustSupport value="true" /> <binding> <strength value="required" /> <valueSet value="https://tiplu.de/fhir/maia/ValueSet/MaiaPresumedDiagnosisAssessmentTypeVS" /> </binding> </element> <element id="RiskAssessment.code.coding:AssessmentType.system"> <path value="RiskAssessment.code.coding.system" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.code.coding:AssessmentType.code"> <path value="RiskAssessment.code.coding.code" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.code.coding:AssessmentType.display"> <path value="RiskAssessment.code.coding.display" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.code.text"> <path value="RiskAssessment.code.text" /> <short value="Name of the custom presumed diagnosis" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.subject"> <path value="RiskAssessment.subject" /> <type> <code value="Reference" /> <targetProfile value="https://tiplu.de/fhir/maia/StructureDefinition/MaiaPatient" /> </type> <mustSupport value="true" /> </element> <element id="RiskAssessment.subject.identifier"> <path value="RiskAssessment.subject.identifier" /> <short value="Patient ID of the referenced patient" /> <comment value="The MAIA FHIR endpoints don't have the possibility to get the patient resource. For this, the resource identifier is mandatory." /> <min value="1" /> <type> <code value="Identifier" /> <profile value="http://fhir.de/StructureDefinition/identifier-pid" /> </type> <mustSupport value="true" /> </element> <element id="RiskAssessment.subject.identifier.type"> <path value="RiskAssessment.subject.identifier.type" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.subject.identifier.system"> <path value="RiskAssessment.subject.identifier.system" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.subject.identifier.value"> <path value="RiskAssessment.subject.identifier.value" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.encounter"> <path value="RiskAssessment.encounter" /> <min value="1" /> <type> <code value="Reference" /> <targetProfile value="https://tiplu.de/fhir/maia/StructureDefinition/MaiaKontaktGesundheitseinrichtung" /> </type> <mustSupport value="true" /> </element> <element id="RiskAssessment.encounter.extension"> <path value="RiskAssessment.encounter.extension" /> <min value="1" /> </element> <element id="RiskAssessment.encounter.extension:AccountIdentifier"> <path value="RiskAssessment.encounter.extension" /> <sliceName value="AccountIdentifier" /> <short value="Account Identifier (German: Fallnummer/Abrechnungsnummer) of the referenced account" /> <comment value="The MAIA FHIR endpoints don't have the possibility to get the account or encounter resource. For this, the resource identifier is mandatory." /> <min value="1" /> <max value="1" /> <type> <code value="Extension" /> <profile value="https://tiplu.de/fhir/maia/StructureDefinition/MaiaAccountIdentifier" /> </type> <mustSupport value="true" /> </element> <element id="RiskAssessment.encounter.extension:AccountIdentifier.value[x]"> <path value="RiskAssessment.encounter.extension.value[x]" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.encounter.extension:AccountIdentifier.value[x].type"> <path value="RiskAssessment.encounter.extension.value[x].type" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.encounter.extension:AccountIdentifier.value[x].system"> <path value="RiskAssessment.encounter.extension.value[x].system" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.encounter.extension:AccountIdentifier.value[x].value"> <path value="RiskAssessment.encounter.extension.value[x].value" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.occurrence[x]"> <path value="RiskAssessment.occurrence[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <min value="1" /> </element> <element id="RiskAssessment.occurrence[x]:occurrenceDateTime"> <path value="RiskAssessment.occurrence[x]" /> <sliceName value="occurrenceDateTime" /> <short value="Last calculation of MAIA" /> <min value="1" /> <max value="1" /> <type> <code value="dateTime" /> </type> <mustSupport value="true" /> </element> <element id="RiskAssessment.performer"> <path value="RiskAssessment.performer" /> <comment value="A Device example with valid MAIA information can be found in the Simplifier project." /> <min value="1" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" /> </type> <mustSupport value="true" /> </element> <element id="RiskAssessment.prediction"> <path value="RiskAssessment.prediction" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.prediction.outcome"> <path value="RiskAssessment.prediction.outcome" /> <comment value="Not Must-Support and not expected to be populated. Rule-based evaluations do not predict a future clinical outcome; they assess whether a defined diagnostic pattern is currently met. The result is fully expressed through qualitativeRisk (severity level) and code (the assessed rule). The outcome element is therefore not applicable in this context." /> </element> <element id="RiskAssessment.prediction.qualitativeRisk"> <path value="RiskAssessment.prediction.qualitativeRisk" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.prediction.qualitativeRisk.coding"> <path value="RiskAssessment.prediction.qualitativeRisk.coding" /> <slicing> <discriminator> <type value="pattern" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> <min value="1" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.prediction.qualitativeRisk.coding:QualitativeRisk"> <path value="RiskAssessment.prediction.qualitativeRisk.coding" /> <sliceName value="QualitativeRisk" /> <min value="1" /> <max value="1" /> <patternCoding> <system value="http://terminology.hl7.org/CodeSystem/risk-probability" /> </patternCoding> <mustSupport value="true" /> <binding> <strength value="required" /> <valueSet value="http://hl7.org/fhir/ValueSet/risk-probability" /> </binding> </element> <element id="RiskAssessment.prediction.qualitativeRisk.coding:QualitativeRisk.system"> <path value="RiskAssessment.prediction.qualitativeRisk.coding.system" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.prediction.qualitativeRisk.coding:QualitativeRisk.code"> <path value="RiskAssessment.prediction.qualitativeRisk.coding.code" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.prediction.qualitativeRisk.coding:QualitativeRisk.display"> <path value="RiskAssessment.prediction.qualitativeRisk.coding.display" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.prediction.when[x]"> <path value="RiskAssessment.prediction.when[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <min value="1" /> </element> <element id="RiskAssessment.prediction.when[x]:whenPeriod"> <path value="RiskAssessment.prediction.when[x]" /> <sliceName value="whenPeriod" /> <min value="1" /> <max value="1" /> <type> <code value="Period" /> </type> <mustSupport value="true" /> </element> <element id="RiskAssessment.prediction.when[x]:whenPeriod.start"> <path value="RiskAssessment.prediction.when[x].start" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.prediction.when[x]:whenPeriod.end"> <path value="RiskAssessment.prediction.when[x].end" /> <mustSupport value="true" /> </element> <element id="RiskAssessment.prediction.rationale"> <path value="RiskAssessment.prediction.rationale" /> <short value="Reasoning" /> <comment value="Provides the patient-specific relevant data points for the result provided by the rule-based evaluation from the patient record if possible." /> <mustSupport value="true" /> </element> </differential> </StructureDefinition>