HL7 FHIR Implementation Guide: Sri Lanka
0.1.0 - STU1

HL7 FHIR Implementation Guide: Sri Lanka, published by Jembi Health Systems. This is not an authorized publication; it is the continuous build for version 0.1.0. This version is based on the current content of https://github.com/jembi/Sri-Lanka and changes regularly. See the Directory of published versions

## Resource Profile: CVDRiskCategory - Detailed Descriptions

Active as of 2023-11-10

Definitions for the cvd-risk-category resource profile.

- Differential Elements Table
- Key Elements Table
- Snapshot Elements Table

Guidance on how to interpret the contents of this table can be found here

0. RiskAssessment
2. RiskAssessment.code
Control | 1..?
Pattern Value | &lt;valueCodeableConcept&nbsp;xmlns=&quot;http://hl7.org/fhir&quot;&gt;<br/>&nbsp;&nbsp;&lt;coding&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;system&nbsp;value=&quot;http://snomed.info/sct&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;code&nbsp;value=&quot;441829007&quot;/&gt;<br/>&nbsp;&nbsp;&lt;/coding&gt;<br/>&lt;/valueCodeableConcept&gt;<br/>
4. RiskAssessment.encounter
Control | 1..?
6. RiskAssessment.occurrence[x]
Control | 1..?
[x] Note | See Choice of Data Types for further information about how to use [x]
Slicing | This element introduces a set of slices on `RiskAssessment.occurrence[x]`. The slices are unordered and Open, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators: type @ $this
8. RiskAssessment.occurrence[x]:occurrenceDateTime
Slice Name | occurrenceDateTime
Control | 1..1
Type | dateTime
[x] Note | See Choice of Data Types for further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
10. RiskAssessment.performer
Control | 1..?
12. RiskAssessment.basis
Control | 1..?
14. RiskAssessment.prediction
Control | 1..?
16. RiskAssessment.prediction.outcome
Control | 1..?
18. RiskAssessment.prediction.probability[x]
[x] Note | See Choice of Data Types for further information about how to use [x]
Slicing | This element introduces a set of slices on `RiskAssessment.prediction.probability[x]`. The slices are unordered and Open, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators: type @ $this
20. RiskAssessment.prediction.probability[x]:probabilityDecimal
Slice Name | probabilityDecimal
Definition | reason(s) why this should be supported.
Control | 0..1
Type | decimal
[x] Note | See Choice of Data Types for further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
22. RiskAssessment.prediction.qualitativeRisk
Control | 1..?
Binding | The codes SHALL be taken from Cardiovascular Risk Categories
24. RiskAssessment.prediction.when[x]
Control | 1..?
[x] Note | See Choice of Data Types for further information about how to use [x]
Slicing | This element introduces a set of slices on `RiskAssessment.prediction.when[x]`. The slices are unordered and Open, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators: type @ $this
26. RiskAssessment.prediction.when[x]:whenRange
Slice Name | whenRange
Control | 1..1
Type | Range
[x] Note | See Choice of Data Types for further information about how to use [x]

Guidance on how to interpret the contents of this table can be found here

0. RiskAssessment
Definition | An assessment of the likely outcome(s) for a patient or other subject as well as the likelihood of each outcome.
Short | Potential outcomes for a subject with likelihood
Control | 0..*
Is Modifier | false
Summary | false
Alternate Names | Prognosis
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. RiskAssessment.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. RiskAssessment.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | 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())
6. RiskAssessment.status
Definition | The status of the RiskAssessment, using the same statuses as an Observation.
Short | registered | preliminary | final | amended +
Control | 1..1
Binding | The codes SHALL be taken from ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 The status of the risk assessment; e.g. preliminary, final, amended, etc.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. RiskAssessment.code
Definition | The type of the risk assessment performed.
Short | Type of assessment
Control | 10..1
Type | CodeableConcept
Is Modifier | false
Summary | true
Pattern Value | &lt;valueCodeableConcept&nbsp;xmlns=&quot;http://hl7.org/fhir&quot;&gt;<br/>&nbsp;&nbsp;&lt;coding&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;system&nbsp;value=&quot;http://snomed.info/sct&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;code&nbsp;value=&quot;441829007&quot;/&gt;<br/>&nbsp;&nbsp;&lt;/coding&gt;<br/>&lt;/valueCodeableConcept&gt;<br/>
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. RiskAssessment.subject
Definition | The patient or group the risk assessment applies to.
Short | Who/what does assessment apply to?
Control | 1..1
Type | Reference(Patient, Group)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. RiskAssessment.encounter
Definition | The encounter where the assessment was performed.
Short | Where was assessment performed?
Control | 10..1
Type | Reference(Encounter)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. RiskAssessment.occurrence[x]
Definition | The date (and possibly time) the risk assessment was performed.
Short | When was assessment made?
Control | 10..1
Type | dateTime, Period
[x] Note | See Choice of Data Types for further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The assessment results lose validity the more time elapses from when they are first made.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `RiskAssessment.occurrence[x]`. The slices are unordered and Closed, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators: type @ $this
16. RiskAssessment.occurrence[x]:occurrenceDateTime
Slice Name | occurrenceDateTime
Definition | The date (and possibly time) the risk assessment was performed.
Short | When was assessment made?
Control | 10..1
Type | dateTime, Period
[x] Note | See Choice of Data Types for further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The assessment results lose validity the more time elapses from when they are first made.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. RiskAssessment.performer
Definition | The provider or software application that performed the assessment.
Short | Who did assessment?
Control | 10..1
Type | Reference(Practitioner, PractitionerRole, Device)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. RiskAssessment.basis
Definition | Indicates the source data considered as part of the assessment (for example, FamilyHistory, Observations, Procedures, Conditions, etc.).
Short | Information used in assessment
Control | 10..*
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. RiskAssessment.prediction
Definition | Describes the expected outcome for the subject.
Short | Outcome predicted
Comments | Multiple repetitions can be used to identify the same type of outcome in different timeframes as well as different types of outcomes.
Control | 10..*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ras-2: Must be <= 100 (`probability is decimal implies (probability as decimal) <= 100`) ras-2: Must be <= 100 (probability is decimal implies (probability as decimal) <= 100)
24. RiskAssessment.prediction.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | 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())
26. RiskAssessment.prediction.outcome
Definition | One of the potential outcomes for the patient (e.g. remission, death, a particular condition).
Short | Possible outcome for the subject
Control | 10..1
Binding | The condition or other outcome; e.g. death, remission, amputation, infection, etc.
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. RiskAssessment.prediction.probability[x]
Definition | Indicates how likely the outcome is (in the specified timeframe).
Short | Likelihood of specified outcome
Comments | 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).
Control | 0..1
Type | Choice of: decimal, Range
[x] Note | See Choice of Data Types for further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ras-1: low and high must be percentages, if present (`(low.empty() or ((low.code = '%') and (low.system = %ucum))) and (high.empty() or ((high.code = '%') and (high.system = %ucum)))`) ras-1: low and high must be percentages, if present ((low.empty() or ((low.code = '%') and (low.system = %ucum))) and (high.empty() or ((high.code = '%') and (high.system = %ucum))))
Slicing | This element introduces a set of slices on `RiskAssessment.prediction.probability[x]`. The slices are unordered and Open, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators: type @ $this
30. RiskAssessment.prediction.probability[x]:probabilityDecimal
Slice Name | probabilityDecimal
Definition | reason(s) why this should be supported. Indicates how likely the outcome is (in the specified timeframe).
Short | Likelihood of specified outcome
Comments | 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).
Control | 0..1
Type | decimal, Range
[x] Note | See Choice of Data Types for further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ras-1: low and high must be percentages, if present (`(low.empty() or ((low.code = '%') and (low.system = %ucum))) and (high.empty() or ((high.code = '%') and (high.system = %ucum)))`) ras-1: low and high must be percentages, if present ((low.empty() or ((low.code = '%') and (low.system = %ucum))) and (high.empty() or ((high.code = '%') and (high.system = %ucum))))
32. RiskAssessment.prediction.qualitativeRisk
Definition | Indicates how likely the outcome is (in the specified timeframe), expressed as a qualitative value (e.g. low, medium, or high).
Short | Likelihood of specified outcome as a qualitative value
Control | 10..1
Binding | The codes SHALL be taken from For example codes, see Cardiovascular Risk Categories http://hl7.org/fhir/ValueSet/risk-probability
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. RiskAssessment.prediction.when[x]
Definition | Indicates the period of time or age range of the subject to which the specified probability applies.
Short | Timeframe or age range
Comments | If not specified, the risk applies "over the subject's lifespan".
Control | 10..1
Type | Range, Period
[x] Note | See Choice of Data Types for further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `RiskAssessment.prediction.when[x]`. The slices are unordered and Closed, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators: type @ $this
36. RiskAssessment.prediction.when[x]:whenRange
Slice Name | whenRange
Definition | Indicates the period of time or age range of the subject to which the specified probability applies.
Short | Timeframe or age range
Comments | If not specified, the risk applies "over the subject's lifespan".
Control | 10..1
Type | Range, Period
[x] Note | See Choice of Data Types for further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be found here

0. RiskAssessment
Definition | An assessment of the likely outcome(s) for a patient or other subject as well as the likelihood of each outcome.
Short | Potential outcomes for a subject with likelihood
Control | 0..*
Is Modifier | false
Summary | false
Alternate Names | Prognosis
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (`contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).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-5: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`)
2. RiskAssessment.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical id of this artifact
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.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
4. RiskAssessment.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. RiskAssessment.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
8. RiskAssessment.language
Definition | The base language in which the resource is written.
Short | Language of the resource content
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).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages: A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. RiskAssessment.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Short | Text summary of the resource, for human interpretation
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Control | 0..1
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. RiskAssessment.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Short | Contained, inline 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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Control | 0..*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
14. RiskAssessment.extension
Definition | May be used to represent additional information that is not part of the basic definition of the resource. 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.
Short | Additional content defined by implementations
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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
16. RiskAssessment.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Short | Extensions that cannot be ignored
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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | 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()`)
18. RiskAssessment.identifier
Definition | Business identifier assigned to the risk assessment.
Short | Unique identifier for the assessment
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
20. RiskAssessment.basedOn
Definition | A reference to the request that is fulfilled by this risk assessment.
Short | Request fulfilled by this assessment
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
22. RiskAssessment.parent
Definition | A reference to a resource that this risk assessment is part of, such as a Procedure.
Short | Part of this occurrence
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
24. RiskAssessment.status
Definition | The status of the RiskAssessment, using the same statuses as an Observation.
Short | registered | preliminary | final | amended +
Control | 1..1
Binding | The codes SHALL be taken from ObservationStatus: The status of the risk assessment; e.g. preliminary, final, amended, etc.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. RiskAssessment.method
Definition | The algorithm, process or mechanism used to evaluate the risk.
Short | Evaluation mechanism
Control | 0..1
Binding | The mechanism or algorithm used to make the assessment; e.g. TIMI, PRISM, Cardiff Type 2 diabetes, etc.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | The method can influence the results of the assessment.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
28. RiskAssessment.code
Definition | The type of the risk assessment performed.
Short | Type of assessment
Control | 1..1
Type | CodeableConcept
Is Modifier | false
Summary | true
Pattern Value | &lt;valueCodeableConcept&nbsp;xmlns=&quot;http://hl7.org/fhir&quot;&gt;<br/>&nbsp;&nbsp;&lt;coding&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;system&nbsp;value=&quot;http://snomed.info/sct&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;code&nbsp;value=&quot;441829007&quot;/&gt;<br/>&nbsp;&nbsp;&lt;/coding&gt;<br/>&lt;/valueCodeableConcept&gt;<br/>
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
30. RiskAssessment.subject
Definition | The patient or group the risk assessment applies to.
Short | Who/what does assessment apply to?
Control | 1..1
Type | Reference(Patient, Group)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
32. RiskAssessment.encounter
Definition | The encounter where the assessment was performed.
Short | Where was assessment performed?
Control | 1..1
Type | Reference(Encounter)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
34. RiskAssessment.occurrence[x]
Definition | The date (and possibly time) the risk assessment was performed.
Short | When was assessment made?
Control | 1..1
Type | dateTime
[x] Note | See Choice of Data Types for further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The assessment results lose validity the more time elapses from when they are first made.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `RiskAssessment.occurrence[x]`. The slices are unordered and Closed, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators: type @ $this
36. RiskAssessment.occurrence[x]:occurrenceDateTime
Slice Name | occurrenceDateTime
Definition | The date (and possibly time) the risk assessment was performed.
Short | When was assessment made?
Control | 1..1
Type | dateTime
[x] Note | See Choice of Data Types for further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The assessment results lose validity the more time elapses from when they are first made.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
38. RiskAssessment.condition
Definition | For assessments or prognosis specific to a particular condition, indicates the condition being assessed.
Short | Condition assessed
Control | 0..1
Type | Reference(Condition)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
40. RiskAssessment.performer
Definition | The provider or software application that performed the assessment.
Short | Who did assessment?
Control | 1..1
Type | Reference(Practitioner, PractitionerRole, Device)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
42. RiskAssessment.reasonCode
Definition | The reason the risk assessment was performed.
Short | Why the assessment was necessary?
Control | 0..*
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
44. RiskAssessment.reasonReference
Definition | Resources supporting the reason the risk assessment was performed.
Short | Why the assessment was necessary?
Control | 0..*
Type | Reference(Condition, Observation, DiagnosticReport, DocumentReference)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
46. RiskAssessment.basis
Definition | Indicates the source data considered as part of the assessment (for example, FamilyHistory, Observations, Procedures, Conditions, etc.).
Short | Information used in assessment
Control | 1..*
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
48. RiskAssessment.prediction
Definition | Describes the expected outcome for the subject.
Short | Outcome predicted
Comments | Multiple repetitions can be used to identify the same type of outcome in different timeframes as well as different types of outcomes.
Control | 1..*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ras-2: Must be <= 100 (`probability is decimal implies (probability as decimal) <= 100`)
50. RiskAssessment.prediction.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
52. RiskAssessment.prediction.extension
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.
Short | Additional content defined by implementations
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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
54. RiskAssessment.prediction.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Short | Extensions that cannot be ignored even if unrecognized
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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | 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()`)
56. RiskAssessment.prediction.outcome
Definition | One of the potential outcomes for the patient (e.g. remission, death, a particular condition).
Short | Possible outcome for the subject
Control | 1..1
Binding | The condition or other outcome; e.g. death, remission, amputation, infection, etc.
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
58. RiskAssessment.prediction.probability[x]
Definition | Indicates how likely the outcome is (in the specified timeframe).
Short | Likelihood of specified outcome
Comments | 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).
Control | 0..1
Type | Choice of: decimal, Range
[x] Note | See Choice of Data Types for further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ras-1: low and high must be percentages, if present (`(low.empty() or ((low.code = '%') and (low.system = %ucum))) and (high.empty() or ((high.code = '%') and (high.system = %ucum)))`)
Slicing | This element introduces a set of slices on `RiskAssessment.prediction.probability[x]`. The slices are unordered and Open, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators: type @ $this
60. RiskAssessment.prediction.probability[x]:probabilityDecimal
Slice Name | probabilityDecimal
Definition | reason(s) why this should be supported.
Short | Likelihood of specified outcome
Comments | 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).
Control | 0..1
Type | decimal
[x] Note | See Choice of Data Types for further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ras-1: low and high must be percentages, if present (`(low.empty() or ((low.code = '%') and (low.system = %ucum))) and (high.empty() or ((high.code = '%') and (high.system = %ucum)))`)
62. RiskAssessment.prediction.qualitativeRisk
Definition | Indicates how likely the outcome is (in the specified timeframe), expressed as a qualitative value (e.g. low, medium, or high).
Short | Likelihood of specified outcome as a qualitative value
Control | 1..1
Binding | The codes SHALL be taken from Cardiovascular Risk Categories
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
64. RiskAssessment.prediction.relativeRisk
Definition | 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.).
Short | Relative likelihood
Control | 0..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Absolute risk is less meaningful than relative risk.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
66. RiskAssessment.prediction.when[x]
Definition | Indicates the period of time or age range of the subject to which the specified probability applies.
Short | Timeframe or age range
Comments | If not specified, the risk applies "over the subject's lifespan".
Control | 1..1
Type | Range
[x] Note | See Choice of Data Types for further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `RiskAssessment.prediction.when[x]`. The slices are unordered and Closed, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators: type @ $this
68. RiskAssessment.prediction.when[x]:whenRange
Slice Name | whenRange
Definition | Indicates the period of time or age range of the subject to which the specified probability applies.
Short | Timeframe or age range
Comments | If not specified, the risk applies "over the subject's lifespan".
Control | 1..1
Type | Range
[x] Note | See Choice of Data Types for further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
70. RiskAssessment.prediction.rationale
Definition | Additional information explaining the basis for the prediction.
Short | Explanation of prediction
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
72. RiskAssessment.mitigation
Definition | A description of the steps that might be taken to reduce the identified risk(s).
Short | How to reduce risk
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | One of the main reasons for assessing risks is to identify whether interventional steps are needed to reduce risk.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
74. RiskAssessment.note
Definition | Additional comments about the risk assessment.
Short | Comments on the risk assessment
Control | 0..*
Type | Annotation
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)