Release 4B Snapshot 3: Connectathon 32 Base

This page is part of the FHIR Specification (v4.3.0: R4B - STU (v5.0.0-snapshot3: R5 Snapshot #3, to support Connectathon 32 ). 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

12.2 12.3 Pattern definition Definition - Content

FHIR Infrastructure icon Maturity Level : 1 Informative

A pattern to be followed by resources that represent a specific proposal, plan and/or order for some sort of action or service.

12.2.1 12.3.1 Scope and Usage

This is NOT a resource. It is not part of the FHIR schema and cannot appear directly in FHIR instances. It is a logical model that defines a pattern adhered to by other resources. This pattern serves two purposes:

  • It offers guidance to work groups designing resources and helps ensure consistency of content created by different work groups
  • It provides a standard "view" that might be useful for implementers in processing and manipulating all resources that adhere to the same pattern. (Tooling that supports this may become available in a future release.)

This pattern describes common properties typically found on "definition" resources. "Definition" resources are resources that describe clinical, administrative or other events that can potentially occur. They do so in a manner that is independent of a particular patient or subject and independent of any particular timeframe. Examples include protocols, order sets, questionnaires, etc. Definitions are intended to be instantiated by Requests (orders, plans and proposals) and Events . For example a PlanDefinition might represent an order set that is subsequently instantiated by a combination of MedicationRequests and ServiceRequests and results in the execution of various MedicationAdministration , Procedure and Observation events. This pattern only applies to definitions of activities, not of objects or roles.

12.2.2 12.3.2 Boundaries and Relationships

This logical model is one of three common workflow patterns . The other two patterns are Event and Request . This pattern is followed by (or is intended to be followed by a number of other FHIR resources /

Both definitions and requests deal with activities that "can" occur, but requests represent a specific intention for something to occur and are bound to a specific context of subject and time, while definitions represent mere "possibility" rather than intention and are independent of a specific subject or timeframe.

12.2.3 12.3.3 Background and Context

This model represents a pattern. It provides a standard list of data elements with cardinalities, data types, definitions, rationale and usage notes that will ideally be adhered to by resources that fall into the "definition" workflow category. However, adherence to this pattern is not mandatory. Not all healthcare domains are the same. Concepts that may be generally applicable (and thus are included in this standard pattern) might still not be relevant everywhere or may be sufficiently uncommon that they are more appropriate to include as extensions than as core properties of the resource. Work groups are encouraged to adjust descriptions, usage notes and rationale to be specific to their resource (e.g. use the term "protocol" or "questionnaire" rather than "definition"). As well, design notes in the comments column marked with [square brackets] identifies areas where domain variation is expected and encouraged. Other variation, including differences in names, cardinalities, data types and the decision to omit an element outright are also possible, but should be discussed with the FHIR Infrastructure work group's Workflow project to ensure the rationale for non-alignment is understood, to confirm that the deviation is necessary and to identify whether any adjustments to the pattern are appropriate.

This pattern provides a linkage to the W5 list of standard data elements. Resources that adhere to this pattern should ensure their w5 mappings are consistent, as is their data element ordering.

12.2.4 12.3.4 References to this Pattern

This pattern is implemented by

12.2.5 12.3.5 Pattern Content

Structure

Name icon Flags icon Card. icon Type icon Description & Constraints icon doco icon
. . Definition I Logical Definition Pattern
. . . url Σ 0..1 uri Logical canonical URL to reference this {{title}} (globally unique)
. . . identifier Σ 0..1 0..* Identifier Business Identifier for {{title}}

. . . version Σ 0..1 string Business version of the {{title}}
. . derivedFromCanonical . title Σ 0..* 0..1 canonical ( Definition string ) Based on FHIR protocol or definition Name for this {{title}} (Human friendly)
. . derivedFromUri . derivedFromCanonical Σ 0..* uri canonical ( Definition ) Based on external FHIR protocol or definition

. . partOf . derivedFromUri Σ 0..* canonical ( Definition uri ) Part of referenced Based on external protocol or definition

. . . replaces partOf Σ 0..* canonical ( Definition ) Request(s) replaced by this request Part of referenced definition

. . . status ?! Σ 1..1 code draft | active | retired | unknown
PublicationStatus ( Required )
. . . experimental ?! Σ 0..1 boolean If for testing purposes, not real usage
. . . subject[x] Σ 0..1 Type of individual the defined service is for
. . . . subjectCodeableConcept CodeableConcept
. . . . subjectReference Reference ( Group )
. . . date Σ 0..1 dateTime Date status first applied
. . . publisher Σ 0..1 Reference ( Practitioner | PractitionerRole | Organization ) The name of the individual or organization that published the {{title}}
. . . contact Σ 0..* ContactDetail Contact details for the publisher

. . . description 0..1 markdown Natural language description of the {{title}}
. . . useContext Σ 0..* UsageContext Content intends to support these contexts

. . . jurisdiction Σ 0..* CodeableConcept Intended jurisdiction for {{title}} (if applicable)
Jurisdiction ValueSet ( Extensible )

. . purpose . category Σ 0..1 0..* CodeableConcept Partitions the {{title}} into one or more categories that can be used to filter searching, to govern access control and/or to guide system behavior.

... purpose 0..1 markdown Why this {{title}} is defined
. . . copyright 0..1 markdown Use and/or publishing restrictions
. . . approvalDate 0..1 date When {{title}} approved by publisher
. . . lastReviewDate 0..1 date Last review date for the {{title}}
. . . effectivePeriod Σ 0..1 Period The effective date range for the {{title}}
. . . performerType Σ 0..1 CodeableConcept Desired kind of service performer
. . . code Σ 0..1 CodeableConcept Service to be done
... product Σ 0..1 CodeableReference ( BiologicallyDerivedProduct | DeviceDefinition | Medication | NutritionProduct | Substance ) Product to use/manipulate

doco Documentation for this format icon

UML Diagram ( Legend )

Definition ( Base ) «Pattern» An absolute URL that is used to identify this {{title}} when it is referenced in a specification, model, design or an instance. This SHALL be a URL, SHOULD be globally unique, and SHOULD be an address at which this {{title}} is (or will be) published. The URL SHOULD include the major version of the {{title}}. For more information see [Technical and Business Versions](resource.html#versions) url : uri [0..1] Business identifiers assigned to this {{title}} by the performer and/or other systems. These identifiers remain constant as the resource is updated and propagates from server to server identifier : Identifier [0..1] [0..*] The identifier that is used to identify this version of the {{title}} when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the {{title}} author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions are orderable version : string [0..1] A natural language name identifying the {{title}}. This name should be usable as an identifier for the module by machine processing applications such as code generation name : string [0..1] A short, descriptive, user-friendly title for the {{title}} title : string [0..1] The canonical URL pointing to another FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this definition derivedFromCanonical : canonical [0..*] « Definition » The URL pointing to an externally-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this definition derivedFromUri : uri [0..*] A larger definition of which this particular definition is a component or step partOf : canonical [0..*] « Definition » Completed or terminated request(s) whose function is taken by this new request replaces : canonical [0..*] « Definition » The current state of the {{title}} (this element modifies the meaning of other elements) status : code [1..1] « The lifecycle status of an artifact. (Strength=Required) PublicationStatus ! » A flag to indicate that this {{title}} is authored for testing purposes (or education/evaluation/marketing), and is not intended to be used for genuine usage (this element modifies the meaning of other elements) experimental : boolean [0..1] A code or group definition that describes the intended subject of instantiations of this definition subject[x] : Element DataType [0..1] « CodeableConcept | Reference ( Group ) » For draft definitions, indicates the date of initial creation. For active definitions, represents the date of activation. For withdrawn definitions, indicates the date of withdrawal date : dateTime [0..1] Helps establish the "authority/credibility" of the {{title}}. May also allow for contact publisher : Reference [0..1] « Practitioner | PractitionerRole | Organization » Contact details to assist a user in finding and communicating with the publisher contact : ContactDetail [0..*] A free text natural language description of the {{title}} from the consumer's perspective description : markdown [0..1] The content was developed with a focus and intent of supporting the contexts that are listed. These terms may be used to assist with indexing and searching of code system definitions useContext : UsageContext [0..*] A jurisdiction in which the {{title}} is intended to be used jurisdiction : CodeableConcept [0..*] « Countries and regions within which this artifact is targeted for use. (Strength=Extensible) Jurisdiction ValueSet JurisdictionValueSet + » Partitions the {{title}} into one or more categories that can be used to filter searching, to govern access control and/or to guide system behavior category : CodeableConcept [0..*] Explains why this {{title}} is needed and why it has been designed as it has purpose : markdown [0..1] A copyright statement relating to the {{title}} and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the {{title}} copyright : markdown [0..1] The date on which the asset content was approved by the publisher. Approval happens once when the content is officially approved for usage approvalDate : date [0..1] The date on which the asset content was last reviewed. Review happens periodically after that, but doesn't change the original approval date lastReviewDate : date [0..1] The period during which the {{title}} content was or is planned to be effective effectivePeriod : Period [0..1] The type of individual that is expected to act upon instances of this definition performerType : CodeableConcept [0..1] A code that identifies the specific service or action that was or is being performed code : CodeableConcept [0..1] Indicates the product supplied or manipulated by this {{title}} product : CodeableReference [0..1] « BiologicallyDerivedProduct | DeviceDefinition | Medication | NutritionProduct | Substance »

Structure

Name icon Flags icon Card. icon Type icon Description & Constraints icon doco icon
. . Definition I Logical Definition Pattern
. . . url Σ 0..1 uri Logical canonical URL to reference this {{title}} (globally unique)
. . . identifier Σ 0..1 0..* Identifier Business Identifier for {{title}}

. . . version Σ 0..1 string Business version of the {{title}}
. . derivedFromCanonical . title Σ 0..* 0..1 canonical ( Definition string ) Based on FHIR protocol or definition Name for this {{title}} (Human friendly)
. . derivedFromUri . derivedFromCanonical Σ 0..* uri canonical ( Definition ) Based on external FHIR protocol or definition

. . partOf . derivedFromUri Σ 0..* canonical ( Definition uri ) Part of referenced Based on external protocol or definition

. . . replaces partOf Σ 0..* canonical ( Definition ) Request(s) replaced by this request Part of referenced definition

. . . status ?! Σ 1..1 code draft | active | retired | unknown
PublicationStatus ( Required )
. . . experimental ?! Σ 0..1 boolean If for testing purposes, not real usage
. . . subject[x] Σ 0..1 Type of individual the defined service is for
. . . . subjectCodeableConcept CodeableConcept
. . . . subjectReference Reference ( Group )
. . . date Σ 0..1 dateTime Date status first applied
. . . publisher Σ 0..1 Reference ( Practitioner | PractitionerRole | Organization ) The name of the individual or organization that published the {{title}}
. . . contact Σ 0..* ContactDetail Contact details for the publisher

. . . description 0..1 markdown Natural language description of the {{title}}
. . . useContext Σ 0..* UsageContext Content intends to support these contexts

. . . jurisdiction Σ 0..* CodeableConcept Intended jurisdiction for {{title}} (if applicable)
Jurisdiction ValueSet ( Extensible )

. . purpose . category Σ 0..1 0..* CodeableConcept Partitions the {{title}} into one or more categories that can be used to filter searching, to govern access control and/or to guide system behavior.

... purpose 0..1 markdown Why this {{title}} is defined
. . . copyright 0..1 markdown Use and/or publishing restrictions
. . . approvalDate 0..1 date When {{title}} approved by publisher
. . . lastReviewDate 0..1 date Last review date for the {{title}}
. . . effectivePeriod Σ 0..1 Period The effective date range for the {{title}}
. . . performerType Σ 0..1 CodeableConcept Desired kind of service performer
. . . code Σ 0..1 CodeableConcept Service to be done
... product Σ 0..1 CodeableReference ( BiologicallyDerivedProduct | DeviceDefinition | Medication | NutritionProduct | Substance ) Product to use/manipulate

doco Documentation for this format icon

UML Diagram ( Legend )

Definition ( Base ) «Pattern» An absolute URL that is used to identify this {{title}} when it is referenced in a specification, model, design or an instance. This SHALL be a URL, SHOULD be globally unique, and SHOULD be an address at which this {{title}} is (or will be) published. The URL SHOULD include the major version of the {{title}}. For more information see [Technical and Business Versions](resource.html#versions) url : uri [0..1] Business identifiers assigned to this {{title}} by the performer and/or other systems. These identifiers remain constant as the resource is updated and propagates from server to server identifier : Identifier [0..1] [0..*] The identifier that is used to identify this version of the {{title}} when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the {{title}} author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions are orderable version : string [0..1] A natural language name identifying the {{title}}. This name should be usable as an identifier for the module by machine processing applications such as code generation name : string [0..1] A short, descriptive, user-friendly title for the {{title}} title : string [0..1] The canonical URL pointing to another FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this definition derivedFromCanonical : canonical [0..*] « Definition » The URL pointing to an externally-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this definition derivedFromUri : uri [0..*] A larger definition of which this particular definition is a component or step partOf : canonical [0..*] « Definition » Completed or terminated request(s) whose function is taken by this new request replaces : canonical [0..*] « Definition » The current state of the {{title}} (this element modifies the meaning of other elements) status : code [1..1] « The lifecycle status of an artifact. (Strength=Required) PublicationStatus ! » A flag to indicate that this {{title}} is authored for testing purposes (or education/evaluation/marketing), and is not intended to be used for genuine usage (this element modifies the meaning of other elements) experimental : boolean [0..1] A code or group definition that describes the intended subject of instantiations of this definition subject[x] : Element DataType [0..1] « CodeableConcept | Reference ( Group ) » For draft definitions, indicates the date of initial creation. For active definitions, represents the date of activation. For withdrawn definitions, indicates the date of withdrawal date : dateTime [0..1] Helps establish the "authority/credibility" of the {{title}}. May also allow for contact publisher : Reference [0..1] « Practitioner | PractitionerRole | Organization » Contact details to assist a user in finding and communicating with the publisher contact : ContactDetail [0..*] A free text natural language description of the {{title}} from the consumer's perspective description : markdown [0..1] The content was developed with a focus and intent of supporting the contexts that are listed. These terms may be used to assist with indexing and searching of code system definitions useContext : UsageContext [0..*] A jurisdiction in which the {{title}} is intended to be used jurisdiction : CodeableConcept [0..*] « Countries and regions within which this artifact is targeted for use. (Strength=Extensible) Jurisdiction ValueSet JurisdictionValueSet + » Partitions the {{title}} into one or more categories that can be used to filter searching, to govern access control and/or to guide system behavior category : CodeableConcept [0..*] Explains why this {{title}} is needed and why it has been designed as it has purpose : markdown [0..1] A copyright statement relating to the {{title}} and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the {{title}} copyright : markdown [0..1] The date on which the asset content was approved by the publisher. Approval happens once when the content is officially approved for usage approvalDate : date [0..1] The date on which the asset content was last reviewed. Review happens periodically after that, but doesn't change the original approval date lastReviewDate : date [0..1] The period during which the {{title}} content was or is planned to be effective effectivePeriod : Period [0..1] The type of individual that is expected to act upon instances of this definition performerType : CodeableConcept [0..1] A code that identifies the specific service or action that was or is being performed code : CodeableConcept [0..1] Indicates the product supplied or manipulated by this {{title}} product : CodeableReference [0..1] « BiologicallyDerivedProduct | DeviceDefinition | Medication | NutritionProduct | Substance »

 

alternate Alternate definitions: Master Definition XML + JSON .

12.2.5.1 12.3.5.1 Terminology Bindings

Path Definition Type Reference
Definition.status

The lifecycle status of an artifact.

Required PublicationStatus
Definition.subject[x] Codes identifying the type of subject intended to be the recpient or focus of the defined action. These should ideally be consistent across definition resources. Unknown No details provided yet
Definition.jurisdiction Countries

This value set defines a base set of codes for country, country subdivision and regions within which this artifact region for indicating where a resource is targeted intended to be used.

Note: The codes for use. countries and country subdivisions are taken from ISO 3166 icon while the codes for "supra-national" regions are from UN Standard country or area codes for statistical use (M49) icon.

 Extensible Jurisdiction ValueSet JurisdictionValueSet
Definition.performerType Identifies types of practitioners, devices or other agents that are intended to perform a defined action. While the detailed constraints of relevant agents will vary by resource, some degree of consistency around recommended codes across request and definition resources would be desirable. Unknown No details provided yet

12.3.6 Definition extensions

Not all resources that adhere to the Definition pattern will necessarily include all pattern elements as 'core' elements. This guide defines extensions for certain pattern elements that may be relevant but are not supported widely enough for direct inclusion in some resources. The extensions relevant for 'definition' resources can be found in the Workflow pattern extensions section of this specification.

12.2.6 12.3.7 State Machine

The following diagram shows the "typical" state machine diagram for resources following the Definition pattern. Note that not all resources will support all states, some resources may choose different names for certain states and some resources may introduce sub-states to the listed states. As well, additional transitions may be supported, including from terminal nodes (e.g. from "withdrawn" back to "active"). That said, most resources should align with this state machine fairly well.

Typical state machine diagram for resources following the Definition pattern

12.2.6.1 12.3.7.1 Mappings

1 1 C 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Citation 1 1 1 1 1 1 C 1 1 1 1 1 1 1 1 1 CompartmentDefinition 1 1 1 1 1 1 ConceptMap 1 1 1 1 1 1 1 1 1 1 1 1 1 Evidence 1 1 1 EvidenceVariable 1 1 C 1 1 1 1 1 ExampleScenario 1 1 1 1 1 1 1 1 1 1 1 ImplementationGuide 1 Library 1 1 C 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 C 1 1 1 1 1 1 1 1 1 1 1 1 1 1 MessageDefinition 1 1 1 NamingSystem 1 1 1 2 N 1 1 1 NC 1 1 1 1 1 1 1 PlanDefinition 1 1 C 1 2 1 1 1 NC 1 1 1 3 N 1 1 1 1 1 1 Questionnaire 1 1 1 1 1 1 ResearchDefinition 1 1 C 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 SearchParameter 1 1 1 1 1 1 1 1 1 StructureMap 1 1 1 1 1 1 1 1 1 1 1 1 1 TerminologyCapabilities 1 1 1 1 1 ValueSet 1 1 C 1 1 1 1 1 1 1 1 1 1
url identifier version title name derivedFromCanonical title derivedFromUri derivedFromCanonical partOf derivedFromUri replaces partOf status experimental subject[x] date publisher contact description useContext jurisdiction category purpose copyright approvalDate lastReviewDate effectivePeriod performerType ActivityDefinition code CapabilityStatement product
ChargeItemDefinition ActivityDefinition 1 1 C 1 1 1 1 1 1 1 1 C 1 1 1 1 1 1 1 1
CodeSystem ChargeItemDefinition 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
EventDefinition 1 1 C 1 1 1 1 1 1 1 1 C 1 1 1 1 1 1 1 1
EvidenceReport Measure 1 C 1 1 1 1 1 1 1 1 1 C 1 1 1 1 1 1 1 1
GraphDefinition MessageDefinition 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
Measure ObservationDefinition 1 1 1 C 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
OperationDefinition 1 1 C 1 1 1 1 1 NC 1 1 1 1 1 1 1 1
ResearchElementDefinition PlanDefinition 1 1 C 1 1 2 1 1 1 NC 1 1 1 3 N 1 1 1 1 1 1 1
StructureDefinition Questionnaire 1 1 C 1 1 1 1 1 1 NC 1 1 C 1 1 1 1 1 1 1 1 1
SubscriptionTopic 1 1 C 1 1 1 N 1 1 1 1 1 1 1 1 1 1 1 1 1
TestScript 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

Each non-grey cell contains a number, the number of elements and extensions (if > 0) mapped in the resource that are mapped to the pattern element in the column. If there are 0 elements and extensions, the number is not shown. In addition, the cell has a color and some character flags.

Colors:

  • Grey: the resource has no element or extension for the pattern element
  • White: the resource has an element that implements the pattern element with the same name
  • Yellow: the resource has a documented extension that implements the pattern element with the same name
  • Blue: the resource has an element that implements the pattern element with a different name
  • Red: the resource has an element that implements that pattern element, but the type or cardinality does not match

Flags:

  • E: pattern element implemented by an extension
  • N: pattern element implemented by an element with a different name
  • T: pattern element implemented by an element with a different type
  • C: pattern element implemented by an element with a different cardinality