STU3 Candidate

This page is part of the FHIR Specification (v1.8.0: STU 3 Draft). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

9.11 Resource RiskAssessment - Content

Clinical Decision Support Work Group Maturity Level : 0 Compartments : Device , Patient , Practitioner

An assessment of the likely outcome(s) for a patient or other subject as well as the likelihood of each outcome.

9.11.1 Scope and Usage

This resource captures predicted outcomes for a patient or population on the basis of source information. Examples include:

  • A prognosis statement for a particular condition
  • Risk of health outcome (heart attack, particular type of cancer) on the basis of lifestyle factors and/or family history
  • List of potential health risks based on a patient's genetic analysis
  • A prediction of outbreak infection rates within a geography based on immunization rates

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.

9.11.2 Boundaries and Relationships

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 RiskAssessment .

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 ).

AllergyIntolerance and RiskAssessment

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.

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.

9.11.3 Background and Context

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 ClinicalImpression and Goal

9.11.4 Resource Content

Structure

Name Flags Card. Type Description & Constraints doco
. . RiskAssessment DomainResource Potential outcomes for a subject with likelihood
. . . identifier Σ 0..1 Identifier Unique identifier for the assessment
. . . basedOn 0..1 Reference ( Any ) Request fulfilled by this assessment
. . . parent 0..1 Reference ( Any ) Part of this occurrence
. . . status 1..1 code registered | preliminary | final | amended +
ObservationStatus ( Required )
. . . code Σ 0..1 CodeableConcept Type of assessment
. . . subject Σ 0..1 Reference ( Patient | Group ) Who/what does assessment apply to?
. . . context Σ 0..1 Reference ( Encounter | EpisodeOfCare ) Where was assessment performed?
. . . occurrence[x] Σ 0..1 When was assessment made?
. . . . occurrenceDateTime dateTime
. . . . occurrencePeriod Period
. . . condition Σ 0..1 Reference ( Condition ) Condition assessed
. . . performer Σ 0..1 Reference ( Practitioner | Device ) Who did assessment?
. . . reason[x] 0..1 Why the assessment was necessary?
. . . . reasonCodeableConcept CodeableConcept
. . . . reasonReference Reference ( Any )
. . . method Σ 0..1 CodeableConcept Evaluation mechanism
. . . basis 0..* Reference ( Any ) Information used in assessment
. . . prediction I 0..* BackboneElement Outcome predicted
Must be <= 100
. . . . outcome 1..1 CodeableConcept Possible outcome for the subject
. . . . probability[x] I 0..1 Likelihood of specified outcome
Risk Probability ( Example )
low and high must be percentages, if present
. . . . . probabilityDecimal decimal
. . . . . probabilityRange Range
. . . . . probabilityCodeableConcept CodeableConcept
. . . . relativeRisk 0..1 decimal Relative likelihood
. . . . when[x] 0..1 Timeframe or age range
. . . . . whenPeriod Period
. . . . . whenRange Range
. . . . rationale 0..1 string Explanation of prediction
. . . mitigation 0..1 string How to reduce risk
. . . note 0..1 Annotation Comments on the risk assessment

doco Documentation for this format

UML Diagram ( Legend )

RiskAssessment ( DomainResource ) Business identifier assigned to the risk assessment identifier : Identifier [0..1] A reference to the request that is fulfilled by this risk assessment basedOn : Reference [0..1] « Any » A reference to a resource that this risk assessment is part of, such as a Procedure parent : Reference [0..1] « Any » The status of the RiskAssessment, using the same statuses as an Observation status : code [1..1] « The status of the risk assessment; e.g. preliminary, final, amended, etc. (Strength=Required) ObservationStatus ! » The type of the risk assessment performed code : CodeableConcept [0..1] The patient or group the risk assessment applies to subject : Reference [0..1] « Patient | Group » The encounter where the assessment was performed context : Reference [0..1] « Encounter | EpisodeOfCare » The date (and possibly time) the risk assessment was performed occurrence[x] : Type [0..1] « dateTime | Period » For assessments or prognosis specific to a particular condition, indicates the condition being assessed condition : Reference [0..1] « Condition » The provider or software application that performed the assessment performer : Reference [0..1] « Practitioner | Device » The reason the risk assessment was performed reason[x] : Type [0..1] « CodeableConcept | Reference ( Any ) » The algorithm, process or mechanism used to evaluate the risk method : CodeableConcept [0..1] Indicates the source data considered as part of the assessment (FamilyHistory, Observations, Procedures, Conditions, etc.) basis : Reference [0..*] « Any » A description of the steps that might be taken to reduce the identified risk(s) mitigation : string [0..1] Additional comments about the risk assessment note : Annotation [0..1] Prediction One of the potential outcomes for the patient (e.g. remission, death, a particular condition) outcome : CodeableConcept [1..1] How likely is the outcome (in the specified timeframe) probability[x] : Type [0..1] « decimal | Range | CodeableConcept ; The likelihood of the occurrence of a specified outcome (Strength=Example) Risk Probability ?? » 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.) relativeRisk : decimal [0..1] Indicates the period of time or age range of the subject to which the specified probability applies when[x] : Type [0..1] « Period | Range » Additional information explaining the basis for the prediction rationale : string [0..1] Describes the expected outcome for the subject prediction [0..*]

XML Template 

<RiskAssessment xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <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 

{doco
  "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/> .doco


[ 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 Element
RiskAssessment.parent added Element
RiskAssessment.status added Element
RiskAssessment.code added Element
RiskAssessment.context added Element
RiskAssessment.occurrence[x] added Element
RiskAssessment.reason[x] added Element
RiskAssessment.note added Element
RiskAssessment.date deleted
RiskAssessment.encounter deleted

See the Full Difference for further information

Structure

Name Flags Card. Type Description & Constraints doco
. . RiskAssessment DomainResource Potential outcomes for a subject with likelihood
. . . identifier Σ 0..1 Identifier Unique identifier for the assessment
. . . basedOn 0..1 Reference ( Any ) Request fulfilled by this assessment
. . . parent 0..1 Reference ( Any ) Part of this occurrence
. . . status 1..1 code registered | preliminary | final | amended +
ObservationStatus ( Required )
. . . code Σ 0..1 CodeableConcept Type of assessment
. . . subject Σ 0..1 Reference ( Patient | Group ) Who/what does assessment apply to?
. . . context Σ 0..1 Reference ( Encounter | EpisodeOfCare ) Where was assessment performed?
. . . occurrence[x] Σ 0..1 When was assessment made?
. . . . occurrenceDateTime dateTime
. . . . occurrencePeriod Period
. . . condition Σ 0..1 Reference ( Condition ) Condition assessed
. . . performer Σ 0..1 Reference ( Practitioner | Device ) Who did assessment?
. . . reason[x] 0..1 Why the assessment was necessary?
. . . . reasonCodeableConcept CodeableConcept
. . . . reasonReference Reference ( Any )
. . . method Σ 0..1 CodeableConcept Evaluation mechanism
. . . basis 0..* Reference ( Any ) Information used in assessment
. . . prediction I 0..* BackboneElement Outcome predicted
Must be <= 100
. . . . outcome 1..1 CodeableConcept Possible outcome for the subject
. . . . probability[x] I 0..1 Likelihood of specified outcome
Risk Probability ( Example )
low and high must be percentages, if present
. . . . . probabilityDecimal decimal
. . . . . probabilityRange Range
. . . . . probabilityCodeableConcept CodeableConcept
. . . . relativeRisk 0..1 decimal Relative likelihood
. . . . when[x] 0..1 Timeframe or age range
. . . . . whenPeriod Period
. . . . . whenRange Range
. . . . rationale 0..1 string Explanation of prediction
. . . mitigation 0..1 string How to reduce risk
. . . note 0..1 Annotation Comments on the risk assessment

doco Documentation for this format

UML Diagram ( Legend )

RiskAssessment ( DomainResource ) Business identifier assigned to the risk assessment identifier : Identifier [0..1] A reference to the request that is fulfilled by this risk assessment basedOn : Reference [0..1] « Any » A reference to a resource that this risk assessment is part of, such as a Procedure parent : Reference [0..1] « Any » The status of the RiskAssessment, using the same statuses as an Observation status : code [1..1] « The status of the risk assessment; e.g. preliminary, final, amended, etc. (Strength=Required) ObservationStatus ! » The type of the risk assessment performed code : CodeableConcept [0..1] The patient or group the risk assessment applies to subject : Reference [0..1] « Patient | Group » The encounter where the assessment was performed context : Reference [0..1] « Encounter | EpisodeOfCare » The date (and possibly time) the risk assessment was performed occurrence[x] : Type [0..1] « dateTime | Period » For assessments or prognosis specific to a particular condition, indicates the condition being assessed condition : Reference [0..1] « Condition » The provider or software application that performed the assessment performer : Reference [0..1] « Practitioner | Device » The reason the risk assessment was performed reason[x] : Type [0..1] « CodeableConcept | Reference ( Any ) » The algorithm, process or mechanism used to evaluate the risk method : CodeableConcept [0..1] Indicates the source data considered as part of the assessment (FamilyHistory, Observations, Procedures, Conditions, etc.) basis : Reference [0..*] « Any » A description of the steps that might be taken to reduce the identified risk(s) mitigation : string [0..1] Additional comments about the risk assessment note : Annotation [0..1] Prediction One of the potential outcomes for the patient (e.g. remission, death, a particular condition) outcome : CodeableConcept [1..1] How likely is the outcome (in the specified timeframe) probability[x] : Type [0..1] « decimal | Range | CodeableConcept ; The likelihood of the occurrence of a specified outcome (Strength=Example) Risk Probability ?? » 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.) relativeRisk : decimal [0..1] Indicates the period of time or age range of the subject to which the specified probability applies when[x] : Type [0..1] « Period | Range » Additional information explaining the basis for the prediction rationale : string [0..1] Describes the expected outcome for the subject prediction [0..*]

XML Template 

<RiskAssessment xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <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 

{doco
  "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/> .doco


[ 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 Element
RiskAssessment.parent added Element
RiskAssessment.status added Element
RiskAssessment.code added Element
RiskAssessment.context added Element
RiskAssessment.occurrence[x] added Element
RiskAssessment.reason[x] added Element
RiskAssessment.note added Element
RiskAssessment.date deleted
RiskAssessment.encounter deleted

See the Full Difference for further information

 

Alternate definitions: Master Definition ( XML , JSON ), XML Schema / Schematron (for ) + JSON Schema , ShEx (for Turtle ), JSON-LD (for RDF as JSON-LD ),

9.11.4.1 Terminology Bindings

Path Definition Type Reference
RiskAssessment.status The status of the risk assessment; e.g. preliminary, final, amended, etc. Required ObservationStatus
RiskAssessment.method The mechanism or algorithm used to make the assessment; e.g. TIMI, PRISM, Cardiff Type 2 diabetes, etc. Unknown No details provided yet
RiskAssessment.prediction.outcome The condition or other outcome; e.g. death, remission, amputation, infection, etc. Unknown No details provided yet
RiskAssessment.prediction.probability[x] The likelihood of the occurrence of a specified outcome Example Risk Probability

9.11.4.2 Constraints

  • ras-1 : On RiskAssessment.prediction.probability[x]: low and high must be percentages, if present ( expression on RiskAssessment.prediction.probability[x]: (low.empty() or ((low.code = '%') and (low.system = %ucum))) and (high.empty() or ((high.code = '%') and (high.system = %ucum))) )
  • ras-2 : On RiskAssessment.prediction: Must be <= 100 ( expression on RiskAssessment.prediction: probability is decimal implies probability.as(decimal) <= 100 )

9.11.5 Open Issues

STU 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 .

9.11.6 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name Type Description Paths In Common
condition reference Condition assessed RiskAssessment.condition
( Condition )
date date When was assessment made? RiskAssessment.occurrenceDateTime 18 Resources
encounter reference Where was assessment performed? RiskAssessment.context
( Encounter ) 		12 Resources
identifier token Unique identifier for the assessment RiskAssessment.identifier 26 Resources
method token Evaluation mechanism RiskAssessment.method
patient reference Who/what does assessment apply to? RiskAssessment.subject
( Patient ) 		31 Resources
performer reference Who did assessment? RiskAssessment.performer
( Practitioner , Device )
subject reference Who/what does assessment apply to? RiskAssessment.subject
( Group , Patient )