{
"description": "The decision to start or end surveillance with respect to a substance or group of substances that is undesirable as treatment for the patient.",
"_filename": "cio-SurveillanceDecision.json",
"package_name": "nictiz.fhir.nl.r4.cio",
"date": null,
"derivation": "constraint",
"publisher": "Nictiz",
"fhirVersion": "4.0.1",
"purpose": "This Flag resource represents the SurveillanceDecision building block for implementations following the information standard [CiO](https://informatiestandaarden.nictiz.nl/wiki/Landingspagina_Contra-indicaties_en_Overgevoeligheden). This profile is based on the Dutch zib ('Zorginformatiebouwsteen', i.e. Health and Care Information Model) SurveillanceDecision that will be part of the 2024 prepublication. Therefore it has no dependency on a corresponding nl-core profile and mappings to zib concepts are not defined. Instead mappings to the CiO data set have been added. It is the intention to derive this profile from a more general nl-core-SurveillanceDecision profile in the future.",
"name": "CioSurveillanceDecision",
"mapping": [ {
"uri": "https://decor.nictiz.nl/pub/cio/cio-html-20231214T100742/ds-2.16.840.1.113883.2.4.3.11.60.26.1.2-2020-04-02T000000.html",
"name": "ART-DECOR Dataset Contraindications and hypersensitivities 2.0.0-beta.2 20231214",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"abstract": false,
"copyright": "Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise.",
"type": "Flag",
"experimental": null,
"resourceType": "StructureDefinition",
"title": "cio SurveillanceDecision",
"package_version": "1.0.0-beta.2",
"status": "draft",
"id": "34618c99-caaa-4a19-9641-9a682df64873",
"kind": "resource",
"url": "http://nictiz.nl/fhir/StructureDefinition/cio-SurveillanceDecision",
"version": "1.0.0-beta.2",
"differential": {
"element": [ {
"id": "Flag",
"path": "Flag",
"alias": [ "BewakingBesluit" ],
"short": "SurveillanceDecision",
"comment": "Note that not all concepts within the SurveillanceDecision building block are mapped to elements within this profile. To convey the complete SurveillanceDecision building block, a Flag resource conforming to this profile SHOULD always be used together with an instance conforming to the [cio-RegistrationData](http://nictiz.nl/fhir/StructureDefinition/cio-RegistrationData) profile wherein `Provenance.target` refers to the Flag resource.",
"mapping": [ {
"map": "cio-dataelement-20-754",
"comment": "SurveillanceDecision",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"constraint": [ {
"key": "cio-SurveillanceDecision-1",
"human": "When Flag.status is 'inactive', Flag.period.end SHALL exist.",
"severity": "error",
"expression": "(status = 'inactive') implies period.end.exists()"
}, {
"key": "cio-SurveillanceDecision-2",
"human": "When the surveillance is stopped (i.e. Flag.status is 'inactive'), a reference to the SurveillanceDecision that was active SHALL be present in Flag.extension:relationSurveillanceDecision.",
"severity": "error",
"expression": "(status = 'inactive') implies extension('http://nictiz.nl/fhir/StructureDefinition/ext-SurveillanceDecision.RelationSurveillanceDecision').exists()"
}, {
"key": "cio-SurveillanceDecision-3",
"human": "A decision basis SHALL be given, either as a reference to a hypersensitivity or reaction in Flag.extension:decisionBasis, or as text in Flag.extension:comment.",
"severity": "error",
"expression": "extension('http://hl7.org/fhir/StructureDefinition/flag-detail').exists() or extension('http://nictiz.nl/fhir/StructureDefinition/ext-Comment').exists()"
} ]
}, {
"id": "Flag.extension:decisionBasis",
"max": "1",
"path": "Flag.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/flag-detail" ]
} ],
"condition": [ "cio-SurveillanceDecision-3" ],
"sliceName": "decisionBasis"
}, {
"path": "Flag.extension.value[x]",
"definition": "The hypersensitivity or reaction in the patient as reason for the surveillance decision.",
"short": "Hypersensitivity / Reaction",
"mapping": [ {
"map": "cio-dataelement-20-765",
"comment": "Hypersensitivity",
"identity": "cio-dataset-200-beta2-20231214"
}, {
"map": "cio-dataelement-20-766",
"comment": "Reaction",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://nictiz.nl/fhir/StructureDefinition/cio-Hypersensitivity", "http://nictiz.nl/fhir/StructureDefinition/cio-Reaction" ]
} ],
"alias": [ "Overgevoeligheid", "Reactie" ],
"id": "Flag.extension:decisionBasis.value[x]",
"condition": [ "cio-SurveillanceDecision-3" ],
"comment": "Whenever the surveillance decision has been taken on another basis than a hypersensitivity or reaction, that basis SHALL be communicated via `.extension:comment`."
}, {
"id": "Flag.extension:relationSurveillanceDecision",
"path": "Flag.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/ext-SurveillanceDecision.RelationSurveillanceDecision" ]
} ],
"condition": [ "cio-SurveillanceDecision-2" ],
"sliceName": "relationSurveillanceDecision"
}, {
"id": "Flag.extension:relationSurveillanceDecision.value[x]",
"path": "Flag.extension.value[x]",
"mapping": [ {
"map": "cio-dataelement-20-828",
"comment": "RelationSurveillanceDecision",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"condition": [ "cio-SurveillanceDecision-2" ]
}, {
"id": "Flag.extension:comment",
"max": "1",
"path": "Flag.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/ext-Comment" ]
} ],
"condition": [ "cio-SurveillanceDecision-3" ],
"sliceName": "comment"
}, {
"id": "Flag.extension:comment.value[x]",
"path": "Flag.extension.value[x]",
"alias": [ "Toelichting" ],
"short": "Comment",
"comment": "Whenever the surveillance decision has been taken on another basis than a hypersensitivity or reaction, that basis SHALL be communicated via this element.",
"mapping": [ {
"map": "cio-dataelement-20-764",
"comment": "Comment",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"condition": [ "cio-SurveillanceDecision-3" ],
"definition": "Textual explanation of the surveillance decision which cannot be expressed in any of the other fields."
}, {
"id": "Flag.identifier",
"min": 1,
"path": "Flag.identifier",
"alias": [ "Identificatienummer" ],
"short": "IdentificationNumber",
"mapping": [ {
"map": "cio-dataelement-20-780",
"comment": "IdentificationNumber",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"definition": "Globally unique number that identifies the instantiation of the information model. The number is composed of an identification of the issuer organization and a unique number assigned by this organization."
}, {
"id": "Flag.status",
"path": "Flag.status",
"comment": "Sending systems that don't record an explicit status, SHOULD use the following guidance to infer a value from DecisionType:\r\n\r\n* When the value of DecisionType is _385652002_, `.status` will be set to _active_.\r\n* When the value of DecisionType is _410546004_, `.status` will be set to _inactive_.",
"mapping": [ {
"map": "cio-dataelement-20-755",
"comment": "DecisionType (implicit)",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"condition": [ "cio-SurveillanceDecision-1", "cio-SurveillanceDecision-2" ]
}, {
"id": "Flag.category",
"min": 1,
"path": "Flag.category",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "$this",
"type": "value"
} ]
}
}, {
"id": "Flag.category:surveillanceDecisionCode",
"max": "1",
"min": 1,
"path": "Flag.category",
"sliceName": "surveillanceDecisionCode",
"patternCodeableConcept": {
"coding": [ {
"code": "225419007",
"system": "http://snomed.info/sct"
} ]
}
}, {
"id": "Flag.code",
"path": "Flag.code",
"alias": [ "OnveiligeStof" ],
"short": "UnsafeSubstance",
"binding": {
"strength": "required",
"valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.26.11.27--20231129131119"
},
"comment": "The message that is be displayed to the user, should indicate the necessity of surveillance on the substance or group of substances present in the UnsafeSubstance concept with the exception of the substances indicated by the SafeWithinUnsafeGroup concept. Since it's semantically not possible to include the content of both concepts within `.code` (e.g. in different `.code.coding`s), the latter concept is represented by the `.extension:safeWithinUnsafeGroup` on `.code`, and the `.code.text` element SHOULD be used to convey the textual representation of the SubstanceForSurveillance concept as a whole. The `.code.text` could read for instance:\r\n* If UnsafeSubstance refers to a single substance:\r\n * (English) 'Monitor the use of {UnsafeSubstance} as treatment for the patient, since this substance is unsafe for the patient.'\r\n * (Dutch) 'Let op het gebruik van {UnsafeSubstance} als behandeling voor de patiënt, aangezien deze stof onveilig is voor de patiënt.'\r\n* If UnsafeSubstance refers to a group of substances, and there possibly are several substances specified within SafeWithinUnsafeGroup:\r\n * (English) 'Monitor the use of {UnsafeSubstance} as treatment for the patient, since this group of substances is unsafe for the patient (with the exception of {SafeWithinUnsafeGroup}).'\r\n * (Dutch) 'Let op het gebruik van {UnsafeSubstance} als behandeling voor de patiënt, aangezien deze groep van stoffen onveilig is voor de patiënt (met uitzondering van {SafeWithinUnsafeGroup}).'",
"mapping": [ {
"map": "cio-dataelement-20-761",
"comment": "UnsafeSubstance",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"definition": "The substance or group of substances that must be monitored completely or with exceptions."
}, {
"id": "Flag.code.extension:safeWithinUnsafeGroup",
"path": "Flag.code.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/ext-SurveillanceDecision.SafeWithinUnsafeGroup" ]
} ],
"sliceName": "safeWithinUnsafeGroup"
}, {
"id": "Flag.code.extension:safeWithinUnsafeGroup.value[x]",
"path": "Flag.code.extension.value[x]",
"mapping": [ {
"map": "cio-dataelement-20-762",
"comment": "SafeWithinUnsafeGroup",
"identity": "cio-dataset-200-beta2-20231214"
} ]
}, {
"id": "Flag.code.text",
"path": "Flag.code.text",
"comment": "For guidance on how to populate this element, see the comment on `.code`.",
"mapping": [ {
"map": "cio-dataelement-20-760",
"comment": "SubstanceForSurveillance (implicit)",
"identity": "cio-dataset-200-beta2-20231214"
} ]
}, {
"id": "Flag.subject",
"path": "Flag.subject",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient", "http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient" ]
} ]
}, {
"id": "Flag.period",
"min": 1,
"path": "Flag.period"
}, {
"id": "Flag.period.start",
"min": 1,
"path": "Flag.period.start",
"alias": [ "BesluitIngangsDatumTijd" ],
"short": "DecisionEffectiveDateTime",
"comment": "When the value of DecisionType is _385652002_ the DecisionEffectiveDateTime SHALL be mapped to `.period.start`. Whenever the DecisionType is _410546004_, the DecisionEffectiveDateTime SHALL be mapped to `.period.end`, and the `.period.start` SHALL not change (i.e. it should be the same as in the Flag resource that is referenced via `.extension:relationSurveillanceDecision`).",
"mapping": [ {
"map": "cio-dataelement-20-757",
"comment": "DecisionEffectiveDateTime",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"definition": "Moment (date and time) when the decision (of type 'start surveillance') should take effect."
}, {
"id": "Flag.period.end",
"path": "Flag.period.end",
"alias": [ "BesluitIngangsDatumTijd" ],
"short": "DecisionEffectiveDateTime",
"comment": "When the value of DecisionType is _385652002_ the DecisionEffectiveDateTime SHALL be mapped to `.period.start`. Whenever the DecisionType is _410546004_, the DecisionEffectiveDateTime SHALL be mapped to `.period.end`, and the `.period.start` SHALL not change (i.e. it should be the same as in the Flag resource that is referenced via `.extension:relationSurveillanceDecision`).",
"mapping": [ {
"map": "cio-dataelement-20-757",
"comment": "DecisionEffectiveDateTime",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"condition": [ "cio-SurveillanceDecision-1" ],
"definition": "Moment (date and time) when the decision (of type 'discontinue surveillance') should take effect."
}, {
"id": "Flag.author",
"path": "Flag.author",
"type": [ {
"code": "Reference",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/pattern-NlCoreHealthProfessionalReference" ],
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole" ]
} ],
"alias": [ "Auteur" ],
"short": "Author",
"mapping": [ {
"map": "cio-dataelement-20-781",
"comment": "Author",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"definition": "The person who is responsible for entering the information in the patient's record."
} ]
},
"contact": [ {
"name": "Nictiz",
"telecom": [ {
"use": "work",
"value": "https://www.nictiz.nl",
"system": "url"
} ]
} ],
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Flag"
}