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12.4 Logical Model Pattern event - Content

FHIR Infrastructure Maturity Level : 1 Informative

A pattern to be followed by resources that represent the performance of some activity, possibly in accordance with a request or service definition.

12.4.1 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" "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.)

An "event" "event" is any description of an activity that has already taken place or that is currently ongoing. It includes resources that primarily describe the "result" "result" of an activity or what was found (e.g. a condition or observation). Examples include encounters, procedures, completed questionnaires, representations of state transitions, etc. It does not include resources that describe objects or roles (e.g. patient, device, location).

12.4.2 Boundaries and Relationships

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

Events are distinct from requests in that an event is primarily focused on what has occurred or is occurring while requests deal with what is "desired" "desired" to occur. While creating a request or definition can be seen as a type of event, the focus of those other resources is not the "creation" "creation" but the desire/intention.

Events are related to Task in that events can be performed in fulfillment of a task and performing an event may involve the execution of one or more tasks. Events do not track the fulfillment of any requests they may be associated with. Tracking of fulfillment is managed through the Task resource.

12.4.3 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 "event" "event" 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 "procedure" "procedure" or "observation" "observation" rather than "event"). "event"). 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.

12.4.4 Logical Model Pattern Content

Structure

0..1 {{title}} did not occur What type Organization organization was acting for
Name Flags Card. Type Description & Constraints doco
. . Event I I Logical Event Pattern
+ Rule: Not Done Reason can only be specified if NotDone status is "true" 'not-done'
+ Rule: reason elements can only be specified if status is NOT 'not-done'
. . . identifier Σ 0..* Identifier Business Identifier for event {{title}}
. . . definition instantiatesCanonical Σ 0..* Reference canonical ( Definition ) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
. . . basedOn Σ 0..* Reference ( Request ) Fulfills plan, proposal or order
. . . partOf Σ 0..* Reference ( Event ) Part of referenced event
. . status . researchStudy ?! Σ 1..1 0..* code Reference ( ResearchStudy ) preparation | in-progress | suspended | aborted | completed | entered-in-error | unknown Associated research study
EventStatus ( Required )
. . notDone . status ?! Σ 1..1 boolean code preparation | in-progress | not-done | suspended | aborted | completed | entered-in-error | unknown
EventStatus ( Required )
. . . notDoneReason statusReason Σ I 0..1 CodeableConcept Why {{title}} did not occur Reason for current status
. . . code Σ 0..1 CodeableConcept What was done
. . . subject Σ 1..1 Reference ( Patient | Group ) Individual service was done for/to
. . context . encounter Σ 0..1 Reference ( Encounter | EpisodeOfCare ) Encounter / Episode associated with event created as part of
. . . occurrence[x] Σ 0..1 When event occurred {{title}} occurred/is occurring
. . . . occurrenceDateTime dateTime
. . . . occurrencePeriod Period
. . . . occurrenceTiming Timing
. . . recorded Σ 0..1 dateTime When {{title}} was first captured in the subject's record
... reported[x] Σ 0..1 Reported rather than primary record
.... reportedBoolean boolean
.... reportedReference Reference ( Patient | RelatedPerson | Practitioner | PractitionerRole | Organization )
. . . performer Σ 0..* BackboneElement Who performed event {{title}} and what they did
. . . role . function Σ 0..1 CodeableConcept Type of performance was done Procedure Performer Role Codes ( Example )
. . . . actor Σ 1..1 Reference ( Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson ) Individual who was performing Who performed {{title}}
. . onBehalfOf . location Σ 0..1 Reference ( Organization Location ) Where {{title}} occurred
. . . reasonCode Σ 0..* CodeableConcept Why was event {{title}} performed?
. . . reasonReference Σ 0..* Reference ( Condition | Observation | Media | DiagnosticReport | DocumentReference ) Why was event {{title}} performed?
. . . note 0..* Annotation Comments made about the event

doco Documentation for this format

UML Diagram ( Legend )

Event ( Logical ) Identifiers Business identifiers assigned to this event {{title}} by the performer or and/or other systems systems. These identifiers remain constant as the resource is updated and propagates from server to server identifier : Identifier [0..*] A The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that was is adhered to in whole or in part by this event {{title}} definition instantiatesCanonical : Reference canonical [0..*] « Definition » The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this {{title}} instantiatesUri : uri [0..*] A plan, proposal or order that is fulfilled in whole or in part by this event {{title}} basedOn : Reference [0..*] « Request » A larger event of which this particular event {{title}} is a component or step partOf : Reference [0..*] « Event » Indicates that this {{title}} is relevant to the specified research study(ies) researchStudy : Reference [0..*] « ResearchStudy » The current state of the event {{title}} (this element modifies the meaning of other elements) status : code [1..1] « Codes identifying the stage lifecycle stage of a event an event. (Strength=Required) EventStatus ! » If true, indicates that Captures the described event (combination of code, timing, performer, etc.) did not actually occur (this element modifies reason for the meaning current state of other elements) notDone : boolean [0..1] Describes why the event did not occur in coded and/or textual form {{title}} notDoneReason statusReason : CodeableConcept [0..1] A code that identifies the specific service or action that was or is being performed code : CodeableConcept [0..1] The individual or set of individuals the action is being or was performed on subject : Reference [1..1] « Patient | Group » The encounter Encounter during which this {{title}} was created or episode of care that establishes to which the context for creation of this event record is tightly associated context encounter : Reference [0..1] « Encounter | EpisodeOfCare » The date date, period or time(s) timing when the activity occurred {{title}} did occur or is occurring occurrence[x] : Type [0..1] « dateTime | Period | Timing » The date the occurrence of the {{title}} was first captured in the record - potentially significantly after the occurrence of the event recorded : dateTime [0..1] Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report reported[x] : Type [0..1] « boolean | Reference ( Patient | RelatedPerson | Practitioner | PractitionerRole | Organization ) » The principal physical location where the {{title}} was performed location : Reference [0..1] « Location » Describes why the event {{title}} occurred in coded or textual form reasonCode : CodeableConcept [0..*] Indicates another resource whose existence justifies this event {{title}} reasonReference : Reference [0..*] « Condition | Observation | Media | DiagnosticReport | DocumentReference » Comments made about the event {{title}} by the performer, subject or other participants note : Annotation [0..*] Performer Describes Distinguishes the type of performance (e.g. primary surgeon, anaesthesiologiest, etc.) involvement of the performer in the {{title}}. [Consider adding examples] role function : CodeableConcept [0..1] Codes describing the types of functional roles performers can take on when performing events (Strength=Example) Procedure Performer Role ?? The device, practitioner, etc. Indicates who or what performed the action {{title}} actor : Reference [1..1] « Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson » The organization the device or practitioner was acting on behalf of onBehalfOf : Reference [0..1] Organization Indicates who or what performed the event {{title}} and how they were involved performer [0..*]

Structure

0..1 {{title}} did not occur What type Organization organization was acting for
Name Flags Card. Type Description & Constraints doco
. . Event I I Logical Event Pattern
+ Rule: Not Done Reason can only be specified if NotDone status is "true" 'not-done'
+ Rule: reason elements can only be specified if status is NOT 'not-done'
. . . identifier Σ 0..* Identifier Business Identifier for event {{title}}
. . . definition instantiatesCanonical Σ 0..* Reference canonical ( Definition ) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
. . . basedOn Σ 0..* Reference ( Request ) Fulfills plan, proposal or order
. . . partOf Σ 0..* Reference ( Event ) Part of referenced event
. . status . researchStudy ?! Σ 1..1 0..* code Reference ( ResearchStudy ) preparation | in-progress | suspended | aborted | completed | entered-in-error | unknown Associated research study
EventStatus ( Required )
. . notDone . status ?! Σ 1..1 boolean code preparation | in-progress | not-done | suspended | aborted | completed | entered-in-error | unknown
EventStatus ( Required )
. . . notDoneReason statusReason Σ I 0..1 CodeableConcept Why {{title}} did not occur Reason for current status
. . . code Σ 0..1 CodeableConcept What was done
. . . subject Σ 1..1 Reference ( Patient | Group ) Individual service was done for/to
. . context . encounter Σ 0..1 Reference ( Encounter | EpisodeOfCare ) Encounter / Episode associated with event created as part of
. . . occurrence[x] Σ 0..1 When event occurred {{title}} occurred/is occurring
. . . . occurrenceDateTime dateTime
. . . . occurrencePeriod Period
. . . . occurrenceTiming Timing
. . . recorded Σ 0..1 dateTime When {{title}} was first captured in the subject's record
... reported[x] Σ 0..1 Reported rather than primary record
.... reportedBoolean boolean
.... reportedReference Reference ( Patient | RelatedPerson | Practitioner | PractitionerRole | Organization )
. . . performer Σ 0..* BackboneElement Who performed event {{title}} and what they did
. . . role . function Σ 0..1 CodeableConcept Type of performance was done Procedure Performer Role Codes ( Example )
. . . . actor Σ 1..1 Reference ( Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson ) Individual who was performing Who performed {{title}}
. . onBehalfOf . location Σ 0..1 Reference ( Organization Location ) Where {{title}} occurred
. . . reasonCode Σ 0..* CodeableConcept Why was event {{title}} performed?
. . . reasonReference Σ 0..* Reference ( Condition | Observation | Media | DiagnosticReport | DocumentReference ) Why was event {{title}} performed?
. . . note 0..* Annotation Comments made about the event

doco Documentation for this format

UML Diagram ( Legend )

Event ( Logical ) Identifiers Business identifiers assigned to this event {{title}} by the performer or and/or other systems systems. These identifiers remain constant as the resource is updated and propagates from server to server identifier : Identifier [0..*] A The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that was is adhered to in whole or in part by this event {{title}} definition instantiatesCanonical : Reference canonical [0..*] « Definition » The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this {{title}} instantiatesUri : uri [0..*] A plan, proposal or order that is fulfilled in whole or in part by this event {{title}} basedOn : Reference [0..*] « Request » A larger event of which this particular event {{title}} is a component or step partOf : Reference [0..*] « Event » Indicates that this {{title}} is relevant to the specified research study(ies) researchStudy : Reference [0..*] « ResearchStudy » The current state of the event {{title}} (this element modifies the meaning of other elements) status : code [1..1] « Codes identifying the stage lifecycle stage of a event an event. (Strength=Required) EventStatus ! » If true, indicates that Captures the described event (combination of code, timing, performer, etc.) did not actually occur (this element modifies reason for the meaning current state of other elements) notDone : boolean [0..1] Describes why the event did not occur in coded and/or textual form {{title}} notDoneReason statusReason : CodeableConcept [0..1] A code that identifies the specific service or action that was or is being performed code : CodeableConcept [0..1] The individual or set of individuals the action is being or was performed on subject : Reference [1..1] « Patient | Group » The encounter Encounter during which this {{title}} was created or episode of care that establishes to which the context for creation of this event record is tightly associated context encounter : Reference [0..1] « Encounter | EpisodeOfCare » The date date, period or time(s) timing when the activity occurred {{title}} did occur or is occurring occurrence[x] : Type [0..1] « dateTime | Period | Timing » The date the occurrence of the {{title}} was first captured in the record - potentially significantly after the occurrence of the event recorded : dateTime [0..1] Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report reported[x] : Type [0..1] « boolean | Reference ( Patient | RelatedPerson | Practitioner | PractitionerRole | Organization ) » The principal physical location where the {{title}} was performed location : Reference [0..1] « Location » Describes why the event {{title}} occurred in coded or textual form reasonCode : CodeableConcept [0..*] Indicates another resource whose existence justifies this event {{title}} reasonReference : Reference [0..*] « Condition | Observation | Media | DiagnosticReport | DocumentReference » Comments made about the event {{title}} by the performer, subject or other participants note : Annotation [0..*] Performer Describes Distinguishes the type of performance (e.g. primary surgeon, anaesthesiologiest, etc.) involvement of the performer in the {{title}}. [Consider adding examples] role function : CodeableConcept [0..1] Codes describing the types of functional roles performers can take on when performing events (Strength=Example) Procedure Performer Role ?? The device, practitioner, etc. Indicates who or what performed the action {{title}} actor : Reference [1..1] « Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson » The organization the device or practitioner was acting on behalf of onBehalfOf : Reference [0..1] Organization Indicates who or what performed the event {{title}} and how they were involved performer [0..*]

 

alternate definitions: Master Definition XML + JSON .

12.4.4.1 Terminology Bindings

Event.performer.role
Path Definition Type Reference
Event.status Codes identifying the stage lifecycle stage of a event an event. Required EventStatus
Event.statusReason Codes identifying the reason for the current state of an event. Unknown No details provided yet
Event.code Codes indicating the details of what is/was done. These will vary significantly based on the type of request event resource and will often be example/preferred rather than extensible/required. Unknown No details provided yet
Event.performer.function Codes describing that describe the types specific involvement of functional roles performers can take on when performing events a performer in an event. E.g. Primary vs. secondary vs. supervising, etc. Example Unknown Procedure Performer Role Codes No details provided yet
Event.reasonCode Codes identifying why this event was necessary. These may be clinical reasons (e.g. diagnoses, symptoms) and/or administrative reasons. While the detailed constraints of relevant reasons will vary by resource, some degree of consistency across resources around recommended codes would be desirable. Unknown No details provided yet

12.4.4.2 Constraints

id Level Location Description Expression
inv-1 : Rule (base) Not Done Reason can only be specified if NotDone status is "true" ( expression 'not-done' : notDone status='not-done' or notDoneReason.exists().not() )
inv-2 Rule (base) reason elements can only be specified if status is NOT 'not-done' status!='not-done' or (reasonCode.exists().not() and reasonReference.exists().not())

12.4.5 Extensions

Not all resources that follow the 'Event' pattern will necessarily include all of the above elements. A set of standard extensions have been defined for use with resources where an element might be "applicable" but is not commonly supported. A list of these can be found on the Event Extensions (event-specific) and Workflow Extensions (shared by events and requests).

12.4.6 State Machine

The following diagram shows the "typical" "typical" state machine diagram for resources following the Event 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 "completed" "completed" back to "in-progress"). "in-progress"). That said, most resources should align with this state machine fairly well.

Typical state machine diagram for resources following the Event pattern

12.4.6.1 Mappings

identifier instantiatesCanonical instantiatesUri basedOn partOf researchStudy status statusReason code subject encounter occurrence[x] recorded reported[x] performer .function.actor location reasonCode reasonReference note
AuditEvent 1 NT 1 NT 1 N 1 NC 1 1 N
ChargeItem 1 1 1 1 1 1 1 T 1 2 NC 1 N 1 N 1
ClaimResponse 1 1 N 1 1 N 1 NT 1 NT
ClinicalImpression 1 1 1 1 1 1 N 1 NC 1
Communication 1 1 1 1 1 1 1 1 C 2 NC 1 1 1
Composition 1 E 1 1 N 1 NTC 1 N 1 NT
Condition 1 E E 2 NTC 1 1 1 NT 1 N 1
Consent 1 E 1 1 NC 1 NC 1 N 2 NT
Contract
Coverage 1 1 1 N 1 N
CoverageEligibilityResponse 1 1 N 1 1 N 1 NT
DetectedIssue 1 1 1 1 NC 1 N 1 NC 1 N 1 NT
DeviceUseStatement 1 1 E 1 E 1 1 N 1 NC 1 1 2 NT
DiagnosticReport 1 1 E E 1 E 1 1 C 1 1 N 2 NC E E E
DocumentManifest 2 N 1 1 N 1 C 1 N 1 NT 1 NC
DocumentReference 2 N 1 1 N 1 C 1 NT 3 NC
Encounter 1 2 N 1 E 1 2 NC 1 C 2 NT 1 NT 1 NC 2 NC 1 2 NT 1 N
EnrollmentResponse 1 1 N 1 C 1 NT 1 N 1 NC
EpisodeOfCare 1 1 N 1 1 NC 1 N 1 N 3 NC 1 N
ExplanationOfBenefit 1 1 1 N 1 N 1 N
FamilyMemberHistory 1 1 1 E 1 1 N 1 1 1
GuidanceResponse 1 1 NT 1 1 C 1 1 N 1 NC 1 1 1
ImagingStudy 1 1 1 N 1 1 NC 1 1 1 N 1 T 1 1 1 1
Immunization 1 E 1 1 1 N 1 N 1 T 1 T 1 1 1 1 1 1
ImmunizationEvaluation 1 1 1 N 1 NT
Invoice 3 NT 1 C 1
Media 1 1 1 E 1 E 1 N 1 C 1 1 N 1 NC E 1 E 1
MedicationAdministration 1 1 N 1 E 1 1 C 1 NT 1 1 N 1 T 1 1 1 1 1
MedicationDispense 1 1 N 1 E 1 1 NT 1 NT 1 C 1 N 1 T 1 1
MedicationStatement 1 1 1 E 1 1 C 1 NT 1 1 N 1 1 1
Observation 1 1 1 E 1 E 1 1 C 1 NT 1 NC E E E
PaymentNotice 1 1 N 1 1 N 1 NT
PaymentReconciliation 1 1 1 N 1 NC 1 NT
Procedure 1 1 1 1 1 E 1 1 1 1 1 NT 1 T 1 1 1 1 1
Provenance 1 N 1 NT 1 N 1 N 1 1 N
QuestionnaireResponse 1 1 1 E 1 1 C 1 1 N 1 NT
RiskAssessment 1 1 1 N E 1 1 1 1 1 1 NC 1 1 1
SupplyDelivery 1 1 1 E 1 C E 1 N 1 NC 1 1 NT E
Task 1 E 1 N 1 NC 1 NT