This page is part of the FHIR Specification (v1.6.0:
STU
3 Ballot 4). The current version which supercedes this version is
5.0.0
.
For
a
full
list
of
available
versions,
see
the
Directory
of
published
versions
. For a full list of available versions, see the
Directory of published versions
.
Page
versions:
. Page versions:
R5
R4B
R4
R3
R2
|
|
Compartments
|
An assessment of the likely outcome(s) for a patient or other subject as well as the likelihood of each outcome.
This resource captures predicted outcomes for a patient or population on the basis of source information. Examples include:
This resource can be used to represent the results of formal scoring/decision support tools that evaluate risk. It can also be used to capture a practitioner's subjective assessment of the patient's risk based on existing knowledge and previous experience.
Risk assessments are a specialized type of observation. We use a specialized resource to provide a simpler mechanism to capture of a series of risks and to associate those risks with time-ranges, probabilities, etc. All risk assertions are captured at one time based on a single set of source inputs. Capture of a single risk MAY be done using the
Observation
class,
particularly
in
circumstances
where
it's
treated
as
a
generic
observation,
but
for
consistency,
all
risk
assessments
and
prognosis
SHOULD
be
captured
using
class, particularly in circumstances where it's treated as a generic observation, but for consistency, all risk assessments and prognosis SHOULD be captured using
RiskAssessment
.
Risk
assessments
may
be
based
on
a
variety
of
factors,
including:
Basic
demographic
information
from
the
.
Risk assessments may be based on a variety of factors, including:
Because so many resources can potentially be used, no limit is placed on what resources can be sent in
RiskAssessment.basis
. However, some resources would be nonsensical for this use (e.g.
MessageHeader
.
However,
some
resources
would
be
nonsensical
for
this
use
(e.g.
).
AllergyIntolerance
and
RiskAssessment
).
AllergyIntolerance and RiskAssessment
AllergyIntolerance
describes
a
specific
type
of
risk
-
propensity
to
reaction
to
a
substance
while
AllergyIntolerance describes a specific type of risk - propensity to reaction to a substance while
RiskAssessment
describes
general
risks
to
a
subject,
not
generally
based
on
a
reaction.
describes general risks to a subject, not generally based on a reaction.
PLANNED CHANGE:
RiskAssessment is one of the Event resources in the FHIR Workflow specification. As such, it is expected to be adjusted to align with the Event workflow pattern which will involve adding a number of additional data elements and potentially renaming a few elements. At present, the work group plans to add all pattern elements with the exception of the "part of" and "in response to" elements which will be handled as extensions. Any concerns about performing such alignment are welcome as ballot comments and/or tracker items.
Risk Assessments can be determined manually by health-care providers based on their professional expertise, by using an algorithmic scoring system or through a combination. Risk assessments can also be computed by decision support systems.
OperationDefinitions
may
be
defined
by
servers
to
generate
risk
assessments
based
on
particular
combinations
of
source
resources
or
other
inputs.
This
resource
is
referenced
by
goal
may be defined by servers to generate risk assessments based on particular combinations of source resources or other inputs.
This resource is referenced by ClinicalImpression and Goal
Structure
| Name | Flags | Card. | Type |
|
|---|---|---|---|---|
|
DomainResource |
|
||
|
Σ | 0..1 | Identifier | Unique identifier for the assessment |
![]() ![]() | 0..1 |
Reference
(
| Request fulfilled by this assessment | |
![]() ![]() | 0..1 | Reference ( Any ) |
|
|
|
1..1 | code |
registered | preliminary | final | amended +
ObservationStatus ( Required ) | |
![]() ![]() | Σ | 0..1 |
|
|
|
Σ | 0..1 |
Reference
(
|
|
|
Σ | 0..1 | Reference ( Encounter | EpisodeOfCare ) |
|
|
Σ | 0..1 | When was assessment made? | |
![]() ![]() ![]() | dateTime | |||
| Period | |||
![]() ![]() | Σ | 0..1 |
Reference
(
|
|
|
Σ | 0..1 |
| Who did assessment? |
![]() ![]() |
|
Why the assessment was necessary? | ||
![]() ![]() ![]() | CodeableConcept | |||
![]() ![]() ![]() | Reference ( Any ) | |||
|
Σ | 0..1 | CodeableConcept |
|
|
0..* | Reference ( Any ) |
|
|
|
I | 0..* | BackboneElement |
Must be <= 100 |
|
1..1 | CodeableConcept |
|
|
|
I | 0..1 |
|
|
|
decimal | |||
|
Range | |||
|
CodeableConcept | |||
|
0..1 | decimal |
|
|
|
0..1 |
|
||
|
Period | |||
|
Range | |||
|
0..1 | string |
|
|
|
0..1 | string |
|
|
| 0..1 | Annotation | Comments on the risk assessment | |
Documentation for this format
|
||||
UML
Diagram
UML Diagram
(
Legend
)
XML
Template
XML Template
<
<RiskAssessment xmlns="http://hl7.org/fhir"><!-- from Resource: id, meta, implicitRules, and language --> <!-- from DomainResource: text, contained, extension, and modifierExtension -->
<</subject> < <</condition> <</encounter> <</performer> <</identifier> <</method> <</basis> < <</outcome> <</probability[x]> < <</when[x]> <<identifier><!-- 0..1 Identifier Unique identifier for the assessment --></identifier> <basedOn><!-- 0..1 Reference(Any) Request fulfilled by this assessment --></basedOn> <parent><!-- 0..1 Reference(Any) Part of this occurrence --></parent> <status value="[code]"/><!-- 1..1 registered | preliminary | final | amended + --> <code><!-- 0..1 CodeableConcept Type of assessment --></code> <subject><!-- 0..1 Reference(Patient|Group) Who/what does assessment apply to? --></subject> <context><!-- 0..1 Reference(Encounter|EpisodeOfCare) Where was assessment performed? --></context> <occurrence[x]><!-- 0..1 dateTime|Period When was assessment made? --></occurrence[x]> <condition><!-- 0..1 Reference(Condition) Condition assessed --></condition> <performer><!-- 0..1 Reference(Practitioner|Device) Who did assessment? --></performer> <reason[x]><!-- 0..1 CodeableConcept|Reference(Any) Why the assessment was necessary? --></reason[x]> <method><!-- 0..1 CodeableConcept Evaluation mechanism --></method> <basis><!-- 0..* Reference(Any) Information used in assessment --></basis> <prediction> <!-- 0..* Outcome predicted --> <outcome><!-- 1..1 CodeableConcept Possible outcome for the subject --></outcome> <probability[x]><!-- 0..1 decimal|Range|CodeableConcept Likelihood of specified outcome --></probability[x]> <relativeRisk value="[decimal]"/><!-- 0..1 Relative likelihood --> <when[x]><!-- 0..1 Period|Range Timeframe or age range --></when[x]> <rationale value="[string]"/><!-- 0..1 Explanation of prediction --> </prediction><<mitigation value="[string]"/><!-- 0..1 How to reduce risk --> <note><!-- 0..1 Annotation Comments on the risk assessment --></note> </RiskAssessment>
JSON
Template
JSON Template
{
"resourceType" : "",
{
"resourceType" : "RiskAssessment",
// from Resource: id, meta, implicitRules, and language
// from DomainResource: text, contained, extension, and modifierExtension
"
"
"
"
"
"
"
"
"
"
"identifier" : { Identifier }, // Unique identifier for the assessment
"basedOn" : { Reference(Any) }, // Request fulfilled by this assessment
"parent" : { Reference(Any) }, // Part of this occurrence
"status" : "<code>", // R! registered | preliminary | final | amended +
"code" : { CodeableConcept }, // Type of assessment
"subject" : { Reference(Patient|Group) }, // Who/what does assessment apply to?
"context" : { Reference(Encounter|EpisodeOfCare) }, // Where was assessment performed?
// occurrence[x]: When was assessment made?. One of these 2:
"occurrenceDateTime" : "<dateTime>",
"occurrencePeriod" : { Period },
"condition" : { Reference(Condition) }, // Condition assessed
"performer" : { Reference(Practitioner|Device) }, // Who did assessment?
// reason[x]: Why the assessment was necessary?. One of these 2:
"reasonCodeableConcept" : { CodeableConcept },
"reasonReference" : { Reference(Any) },
"method" : { CodeableConcept }, // Evaluation mechanism
"basis" : [{ Reference(Any) }], // Information used in assessment
"prediction" : [{ // Outcome predicted
"outcome" : { CodeableConcept }, // R! Possible outcome for the subject
// probability[x]: Likelihood of specified outcome. One of these 3:
">,
" },
" },
"
"probabilityDecimal" : <decimal>,
"probabilityRange" : { Range },
"probabilityCodeableConcept" : { CodeableConcept },
"relativeRisk" : <decimal>, // Relative likelihood
// when[x]: Timeframe or age range. One of these 2:
" },
" },
"
"whenPeriod" : { Period },
"whenRange" : { Range },
"rationale" : "<string>" // Explanation of prediction
}],
"
"mitigation" : "<string>", // How to reduce risk
"note" : { Annotation } // Comments on the risk assessment
}
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> .[ a fhir:RiskAssessment; fhir:nodeRole fhir:treeRoot; # if this is the parser root # from Resource: .id, .meta, .implicitRules, and .language # from DomainResource: .text, .contained, .extension, and .modifierExtension fhir:RiskAssessment.identifier [ Identifier ]; # 0..1 Unique identifier for the assessment fhir:RiskAssessment.basedOn [ Reference(Any) ]; # 0..1 Request fulfilled by this assessment fhir:RiskAssessment.parent [ Reference(Any) ]; # 0..1 Part of this occurrence fhir:RiskAssessment.status [ code ]; # 1..1 registered | preliminary | final | amended + fhir:RiskAssessment.code [ CodeableConcept ]; # 0..1 Type of assessment fhir:RiskAssessment.subject [ Reference(Patient|Group) ]; # 0..1 Who/what does assessment apply to? fhir:RiskAssessment.context [ Reference(Encounter|EpisodeOfCare) ]; # 0..1 Where was assessment performed? # RiskAssessment.occurrence[x] : 0..1 When was assessment made?. One of these 2 fhir:RiskAssessment.occurrenceDateTime [ dateTime ] fhir:RiskAssessment.occurrencePeriod [ Period ] fhir:RiskAssessment.condition [ Reference(Condition) ]; # 0..1 Condition assessed fhir:RiskAssessment.performer [ Reference(Practitioner|Device) ]; # 0..1 Who did assessment? # RiskAssessment.reason[x] : 0..1 Why the assessment was necessary?. One of these 2 fhir:RiskAssessment.reasonCodeableConcept [ CodeableConcept ] fhir:RiskAssessment.reasonReference [ Reference(Any) ] fhir:RiskAssessment.method [ CodeableConcept ]; # 0..1 Evaluation mechanism fhir:RiskAssessment.basis [ Reference(Any) ], ... ; # 0..* Information used in assessment fhir:RiskAssessment.prediction [ # 0..* Outcome predicted fhir:RiskAssessment.prediction.outcome [ CodeableConcept ]; # 1..1 Possible outcome for the subject # RiskAssessment.prediction.probability[x] : 0..1 Likelihood of specified outcome. One of these 3 fhir:RiskAssessment.prediction.probabilityDecimal [ decimal ] fhir:RiskAssessment.prediction.probabilityRange [ Range ] fhir:RiskAssessment.prediction.probabilityCodeableConcept [ CodeableConcept ] fhir:RiskAssessment.prediction.relativeRisk [ decimal ]; # 0..1 Relative likelihood # RiskAssessment.prediction.when[x] : 0..1 Timeframe or age range. One of these 2 fhir:RiskAssessment.prediction.whenPeriod [ Period ] fhir:RiskAssessment.prediction.whenRange [ Range ] fhir:RiskAssessment.prediction.rationale [ string ]; # 0..1 Explanation of prediction ], ...; fhir:RiskAssessment.mitigation [ string ]; # 0..1 How to reduce risk fhir:RiskAssessment.note [ Annotation ]; # 0..1 Comments on the risk assessment ]
Changes since DSTU2
| RiskAssessment | |
| RiskAssessment.basedOn | added |
| RiskAssessment.parent | added |
| RiskAssessment.status | added |
| RiskAssessment.code | added |
| RiskAssessment.context | added |
| RiskAssessment.occurrence[x] | added |
| RiskAssessment.reason[x] | added |
| RiskAssessment.note | added |
| RiskAssessment.date | deleted |
| RiskAssessment.encounter | deleted |
See the Full Difference for further information
Structure
| Name | Flags | Card. | Type |
|
|---|---|---|---|---|
|
DomainResource |
|
||
|
Σ | 0..1 | Identifier | Unique identifier for the assessment |
![]() ![]() | 0..1 |
Reference
(
| Request fulfilled by this assessment | |
![]() ![]() | 0..1 | Reference ( Any ) |
|
|
|
1..1 | code |
registered | preliminary | final | amended +
ObservationStatus ( Required ) | |
![]() ![]() | Σ | 0..1 |
|
|
|
Σ | 0..1 |
Reference
(
|
|
|
Σ | 0..1 | Reference ( Encounter | EpisodeOfCare ) |
|
|
Σ | 0..1 | When was assessment made? | |
![]() ![]() ![]() | dateTime | |||
| Period | |||
![]() ![]() | Σ | 0..1 |
Reference
(
|
|
|
Σ | 0..1 |
| Who did assessment? |
![]() ![]() |
|
Why the assessment was necessary? | ||
![]() ![]() ![]() | CodeableConcept | |||
![]() ![]() ![]() | Reference ( Any ) | |||
|
Σ | 0..1 | CodeableConcept |
|
|
0..* | Reference ( Any ) |
|
|
|
I | 0..* | BackboneElement |
Must be <= 100 |
|
1..1 | CodeableConcept |
|
|
|
I | 0..1 |
|
|
|
decimal | |||
|
Range | |||
|
CodeableConcept | |||
|
0..1 | decimal |
|
|
|
0..1 |
|
||
|
Period | |||
|
Range | |||
|
0..1 | string |
|
|
|
0..1 | string |
|
|
| 0..1 | Annotation | Comments on the risk assessment | |
Documentation for this format
|
||||
XML
Template
XML Template
<
<RiskAssessment xmlns="http://hl7.org/fhir"><!-- from Resource: id, meta, implicitRules, and language --> <!-- from DomainResource: text, contained, extension, and modifierExtension -->
<</subject> < <</condition> <</encounter> <</performer> <</identifier> <</method> <</basis> < <</outcome> <</probability[x]> < <</when[x]> <<identifier><!-- 0..1 Identifier Unique identifier for the assessment --></identifier> <basedOn><!-- 0..1 Reference(Any) Request fulfilled by this assessment --></basedOn> <parent><!-- 0..1 Reference(Any) Part of this occurrence --></parent> <status value="[code]"/><!-- 1..1 registered | preliminary | final | amended + --> <code><!-- 0..1 CodeableConcept Type of assessment --></code> <subject><!-- 0..1 Reference(Patient|Group) Who/what does assessment apply to? --></subject> <context><!-- 0..1 Reference(Encounter|EpisodeOfCare) Where was assessment performed? --></context> <occurrence[x]><!-- 0..1 dateTime|Period When was assessment made? --></occurrence[x]> <condition><!-- 0..1 Reference(Condition) Condition assessed --></condition> <performer><!-- 0..1 Reference(Practitioner|Device) Who did assessment? --></performer> <reason[x]><!-- 0..1 CodeableConcept|Reference(Any) Why the assessment was necessary? --></reason[x]> <method><!-- 0..1 CodeableConcept Evaluation mechanism --></method> <basis><!-- 0..* Reference(Any) Information used in assessment --></basis> <prediction> <!-- 0..* Outcome predicted --> <outcome><!-- 1..1 CodeableConcept Possible outcome for the subject --></outcome> <probability[x]><!-- 0..1 decimal|Range|CodeableConcept Likelihood of specified outcome --></probability[x]> <relativeRisk value="[decimal]"/><!-- 0..1 Relative likelihood --> <when[x]><!-- 0..1 Period|Range Timeframe or age range --></when[x]> <rationale value="[string]"/><!-- 0..1 Explanation of prediction --> </prediction><<mitigation value="[string]"/><!-- 0..1 How to reduce risk --> <note><!-- 0..1 Annotation Comments on the risk assessment --></note> </RiskAssessment>
JSON
Template
JSON Template
{
"resourceType" : "",
{
"resourceType" : "RiskAssessment",
// from Resource: id, meta, implicitRules, and language
// from DomainResource: text, contained, extension, and modifierExtension
"
"
"
"
"
"
"
"
"
"
"identifier" : { Identifier }, // Unique identifier for the assessment
"basedOn" : { Reference(Any) }, // Request fulfilled by this assessment
"parent" : { Reference(Any) }, // Part of this occurrence
"status" : "<code>", // R! registered | preliminary | final | amended +
"code" : { CodeableConcept }, // Type of assessment
"subject" : { Reference(Patient|Group) }, // Who/what does assessment apply to?
"context" : { Reference(Encounter|EpisodeOfCare) }, // Where was assessment performed?
// occurrence[x]: When was assessment made?. One of these 2:
"occurrenceDateTime" : "<dateTime>",
"occurrencePeriod" : { Period },
"condition" : { Reference(Condition) }, // Condition assessed
"performer" : { Reference(Practitioner|Device) }, // Who did assessment?
// reason[x]: Why the assessment was necessary?. One of these 2:
"reasonCodeableConcept" : { CodeableConcept },
"reasonReference" : { Reference(Any) },
"method" : { CodeableConcept }, // Evaluation mechanism
"basis" : [{ Reference(Any) }], // Information used in assessment
"prediction" : [{ // Outcome predicted
"outcome" : { CodeableConcept }, // R! Possible outcome for the subject
// probability[x]: Likelihood of specified outcome. One of these 3:
">,
" },
" },
"
"probabilityDecimal" : <decimal>,
"probabilityRange" : { Range },
"probabilityCodeableConcept" : { CodeableConcept },
"relativeRisk" : <decimal>, // Relative likelihood
// when[x]: Timeframe or age range. One of these 2:
" },
" },
"
"whenPeriod" : { Period },
"whenRange" : { Range },
"rationale" : "<string>" // Explanation of prediction
}],
"
"mitigation" : "<string>", // How to reduce risk
"note" : { Annotation } // Comments on the risk assessment
}
Alternate
definitions:
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> .[ a fhir:RiskAssessment; fhir:nodeRole fhir:treeRoot; # if this is the parser root # from Resource: .id, .meta, .implicitRules, and .language # from DomainResource: .text, .contained, .extension, and .modifierExtension fhir:RiskAssessment.identifier [ Identifier ]; # 0..1 Unique identifier for the assessment fhir:RiskAssessment.basedOn [ Reference(Any) ]; # 0..1 Request fulfilled by this assessment fhir:RiskAssessment.parent [ Reference(Any) ]; # 0..1 Part of this occurrence fhir:RiskAssessment.status [ code ]; # 1..1 registered | preliminary | final | amended + fhir:RiskAssessment.code [ CodeableConcept ]; # 0..1 Type of assessment fhir:RiskAssessment.subject [ Reference(Patient|Group) ]; # 0..1 Who/what does assessment apply to? fhir:RiskAssessment.context [ Reference(Encounter|EpisodeOfCare) ]; # 0..1 Where was assessment performed? # RiskAssessment.occurrence[x] : 0..1 When was assessment made?. One of these 2 fhir:RiskAssessment.occurrenceDateTime [ dateTime ] fhir:RiskAssessment.occurrencePeriod [ Period ] fhir:RiskAssessment.condition [ Reference(Condition) ]; # 0..1 Condition assessed fhir:RiskAssessment.performer [ Reference(Practitioner|Device) ]; # 0..1 Who did assessment? # RiskAssessment.reason[x] : 0..1 Why the assessment was necessary?. One of these 2 fhir:RiskAssessment.reasonCodeableConcept [ CodeableConcept ] fhir:RiskAssessment.reasonReference [ Reference(Any) ] fhir:RiskAssessment.method [ CodeableConcept ]; # 0..1 Evaluation mechanism fhir:RiskAssessment.basis [ Reference(Any) ], ... ; # 0..* Information used in assessment fhir:RiskAssessment.prediction [ # 0..* Outcome predicted fhir:RiskAssessment.prediction.outcome [ CodeableConcept ]; # 1..1 Possible outcome for the subject # RiskAssessment.prediction.probability[x] : 0..1 Likelihood of specified outcome. One of these 3 fhir:RiskAssessment.prediction.probabilityDecimal [ decimal ] fhir:RiskAssessment.prediction.probabilityRange [ Range ] fhir:RiskAssessment.prediction.probabilityCodeableConcept [ CodeableConcept ] fhir:RiskAssessment.prediction.relativeRisk [ decimal ]; # 0..1 Relative likelihood # RiskAssessment.prediction.when[x] : 0..1 Timeframe or age range. One of these 2 fhir:RiskAssessment.prediction.whenPeriod [ Period ] fhir:RiskAssessment.prediction.whenRange [ Range ] fhir:RiskAssessment.prediction.rationale [ string ]; # 0..1 Explanation of prediction ], ...; fhir:RiskAssessment.mitigation [ string ]; # 0..1 How to reduce risk fhir:RiskAssessment.note [ Annotation ]; # 0..1 Comments on the risk assessment ]
Changes since DSTU2
| RiskAssessment | |
| RiskAssessment.basedOn | added |
| RiskAssessment.parent | added |
| RiskAssessment.status | added |
| RiskAssessment.code | added |
| RiskAssessment.context | added |
| RiskAssessment.occurrence[x] | added |
| RiskAssessment.reason[x] | added |
| RiskAssessment.note | added |
| RiskAssessment.date | deleted |
| RiskAssessment.encounter | deleted |
See the Full Difference for further information
Alternate definitions: Master Definition (
XML
,
JSON
),
XML
Schema
/
Schematron
,
Resource
Profile
(
XML
,
(for ) +
JSON
Schema
,
ShEx
(for
Turtle
),
Questionnaire
)
| Path | Definition | Type | Reference |
|---|---|---|---|
| RiskAssessment.status |
|
|
|
| RiskAssessment.method |
|
Unknown |
|
| RiskAssessment.prediction.outcome | The condition or other outcome; e.g. death, remission, amputation, infection, etc. | Unknown |
|
| RiskAssessment.prediction.probability[x] | The likelihood of the occurrence of a specified outcome | Example |
|
on RiskAssessment.prediction.probability[x]:
(low.empty() or ((low.code = '%') and (low.system = %ucum))) and (high.empty() or ((high.code = '%') and (high.system = %ucum)))
)
on RiskAssessment.prediction:
probability is decimal implies probability.as(decimal) <= 100
)
DSTU Note: There are several open issues around the risk assessment resource:
- Is there an existing code system we can use as a recommended value set for risk probabilties?
- Should risk assessments apply to devices, locations or any other resources (as part of the 80%)?
- Is identification of risk assessment method part of the 80%?
- Is relative risk in the 80%?
Feedback is sought here
![]()
..
Search parameters for this resource. The
common parameters
also apply. See
Searching
for
more
information
about
searching
in
REST,
messaging,
and
services.
for more information about searching in REST, messaging, and services.
| Name | Type | Description | Paths |
| condition | reference |
|
RiskAssessment.condition
( Condition ) |
| date | date |
|
|
| encounter | reference |
|
( Encounter ) |
| identifier | token |
|
RiskAssessment.identifier |
| method | token |
|
RiskAssessment.method |
| patient | reference |
|
RiskAssessment.subject
( Patient ) |
| performer | reference |
|
RiskAssessment.performer
( |
| subject | reference |
|
RiskAssessment.subject
( |