FHIR Release 3 (STU) Current Build
This page is part of FHIR STU 3 (v3.0.1) in it's permanent home (it will always be available at this URL). It has been superceded by R4 . For a full list of available versions, see the Directory of published versions .

Detectedissue.profile.xml

Clinical Decision Support Work Group Maturity Level : N/A Ballot Standards Status : Informative Compartments : Device , Patient , Practitioner

Raw XML ( canonical form + also see XML Format Specification )

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StructureDefinition for detectedissue

<?xml version="1.0" encoding="UTF-8"?>
<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="DetectedIssue"/> 
  <meta> 
    

    <lastUpdated value="2019-06-08T15:25:42.576+00:00"/> 
  </meta> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">
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            <a href="formats.html#table" title="The logical name of the element">Name</a> 
          </th> 
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <a href="formats.html#table" title="Information about the use of the element">Flags</a> 
          </th> 
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <a href="formats.html#table" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a> 
          </th> 
          <th class="hierarchy" style="width: 100px">
            <a href="formats.html#table" title="Reference to the type of the element">Type</a> 
          </th> 
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="formats.html#table" title="Additional information about the element">Description &amp; Constraints</a> 
            <span style="float: right">
              <a href="formats.html#table" title="Legend for this format">
                <img alt="doco" src="help16.png" style="background-color: inherit"/> 
              </a> 
            </span> 
          </th> 
        </tr> 
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            <span title="DetectedIssue : Indicates an actual or potential clinical issue with or between one or
             more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, Ineffective
             treatment frequency, Procedure-condition conflict, etc.">DetectedIssue</span> 
            <a name="DetectedIssue"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px

           padding:0px 4px 0px 4px">
            <a href="versions.html#std-process" style="padding-left: 3px; padding-right: 3px; border: 1px grey solid; font-weight: bold; color:
             black; background-color: #fff5e6" title="Standards Status = Trial Use">TU</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="domainresource.html">DomainResource</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Clinical issue with action
            <br/>  Elements defined in Ancestors: 
            <a href="resource.html#Resource" title="The logical id of the resource, as used in the URL for the resource. Once assigned, this
             value never changes.">id</a> , 
            <a href="resource.html#Resource" title="The metadata about the resource. This is content that is maintained by the infrastructure.
             Changes to the content may not always be associated with version changes to the resource., 

             Changes to the content might not always be associated with version changes to the resource.">meta</a> , 

            <a href="resource.html#Resource" title="A reference to a set of rules that were followed when the resource was constructed, and
             which must be understood when processing the content., 

             which must be understood when processing the content. Often, this is a reference to an
             implementation guide that defines the special rules along with other profiles etc.">implicitRules</a> , 

            <a href="resource.html#Resource" title="The base language in which the resource is written.">language</a> , 
            A human-readable narrative that contains a summary of the resource, and may be used to

            <a href="domainresource.html#DomainResource" title="A human-readable narrative that contains a summary of the resource and can be used to
             represent the content of the resource to a human. The narrative need not encode all the
             structured data, but is required to contain sufficient detail to make it &quot;clinically
             safe&quot; for a human to just read the narrative. Resource definitions may define what
             content should be represented in the narrative to ensure clinical safety.">text</a> , 
            <a href="domainresource.html#DomainResource" title="These resources do not have an independent existence apart from the resource that contains
             them - they cannot be identified independently, and nor can they have their own independent
             transaction scope.">contained</a> , 
            <a href="domainresource.html#DomainResource" title="May be used to represent additional information that is not part of the basic definition
             of the resource. In order to make the use of extensions safe and manageable, there is
             a strict set of governance  applied to the definition and use of extensions. Though any
             implementer is allowed to define an extension, there is a set of requirements that SHALL
             be met as part of the definition of the extension., 

             of the resource. To make the use of extensions safe and manageable, there is a strict
             set of governance  applied to the definition and use of extensions. Though any implementer
             can define an extension, there is a set of requirements that SHALL be met as part of the
             definition of the extension.">extension</a> , 

            <a href="domainresource.html#DomainResource" title="May be used to represent additional information that is not part of the basic definition
             of the resource, and that modifies the understanding of the element that contains it.
             Usually modifier elements provide negation or qualification. In order to make the use
             of extensions safe and manageable, there is a strict set of governance applied to the
             definition and use of extensions. Though any implementer is allowed to define an extension,
             there is a set of requirements that SHALL be met as part of the definition of the extension.
             Applications processing a resource are required to check for modifier extensions.

             of the resource and that modifies the understanding of the element that contains it and/or
             the understanding of the containing element's descendants. Usually modifier elements provide
             negation or qualification. To make the use of extensions safe and manageable, there is
             a strict set of governance applied to the definition and use of extensions. Though any
             implementer is allowed to define an extension, there is a set of requirements that SHALL
             be met as part of the definition of the extension. Applications processing a resource
             are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource
             (including cannot change the meaning of modifierExtension itself).">modifierExtension</a> 

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        </tr> 
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            <span title="DetectedIssue.identifier : Business identifier associated with the detected issue record.">identifier</span> 
            <a name="DetectedIssue.identifier"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            

            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; background-color: white" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px

           padding:0px 4px 0px 4px">0..*</td> 

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#Identifier">Identifier</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px

           padding:0px 4px 0px 4px">Unique id for the detected issue
            <br/>            </td> 
        </tr> 
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <span title="DetectedIssue.status : Indicates the status of the detected issue.">status</span> 
            <a name="DetectedIssue.status"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            
            

            <a href="conformance-rules.html#isModifier" style="padding-left: 3px; padding-right: 3px; color: black; background-color: white" title="This element is a modifier element">?!</a> 
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; background-color: white" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">1..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#code">code</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">registered | preliminary | final | amended +
            <br/>  
             (
            )

            <a href="valueset-observation-status.html" title="Indicates the status of the identified issue.">ObservationStatus</a>  (
            <a href="terminologies.html#required" title="To be conformant, the concept in this element SHALL be from the specified value set.">Required</a> )
          </td> 
        </tr> 
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            <span title="DetectedIssue.code : Identifies the general type of issue identified.">code</span>             <a name="DetectedIssue.code"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            

            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; background-color: white" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Issue Category, e.g. drug-drug, duplicate therapy, etc.
            <br/>  
            <a href="valueset-detectedissue-category.html" title="Codes identifying the general type of detected issue; e.g. Drug-drug interaction, Timing
             issue, Duplicate therapy, etc.">Detected Issue Category</a>  (
            <a href="terminologies.html#preferred" title="Instances are encouraged to draw from the specified codes for interoperability purposes
             but are not required to do so to be considered conformant.">Preferred</a> )
          </td> 
        </tr> 
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <span title="DetectedIssue.severity : Indicates the degree of importance associated with the identified
             issue based on the potential impact on the patient.">severity</span> 
            <a name="DetectedIssue.severity"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            

            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; background-color: white" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#code">code</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">high | moderate | low
            <br/>  
            <a href="valueset-detectedissue-severity.html" title="Indicates the potential degree of impact of the identified issue on the patient.">DetectedIssueSeverity</a>  (
            )

            <a href="terminologies.html#required" title="To be conformant, the concept in this element SHALL be from the specified value set.">Required</a> )
          </td> 
        </tr> 
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <span title="DetectedIssue.patient : Indicates the patient whose record the detected issue is associated
             with.">patient</span> 
            <a name="DetectedIssue.patient"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            

            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; background-color: white" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            (

            <a href="references.html#Reference">Reference</a> (
            <a href="patient.html">Patient</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Associated patient</td> 
        </tr> 
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <span title="DetectedIssue.identified[x] : The date or period when the detected issue was initially
             identified.">identified[x]</span> 
            <a name="DetectedIssue.identified_x_"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            

            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; background-color: white" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">When identified</td> 
        </tr>         <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAR
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            <span title="A date, date-time or partial date (e.g. just year or year + month).  If hours and minutes
             are specified, a time zone SHALL be populated. The format is a union of the schema types
             gYear, gYearMonth, date and dateTime. Seconds must be provided due to schema type constraints
             but may be zero-filled and may be ignored.                 Dates SHALL be valid dates.">identifiedDateTime</span> 
          </td>           <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#dateTime">dateTime</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px

           padding:0px 4px 0px 4px"/> 
        </tr>         <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <a name="DetectedIssue.author"> </a> 
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; background-color: white" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            (

            <a href="references.html#Reference">Reference</a> (
            <a href="practitioner.html">Practitioner</a>  | 
            <a href="practitionerrole.html">PractitionerRole</a>  | 
            <a href="device.html">Device</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">The provider or device that identified the issue</td> 
        </tr> 
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
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            <span title="DetectedIssue.implicated : Indicates the resource representing the current activity or
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            <a name="DetectedIssue.implicated"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; background-color: white" title="This element is included in summaries">Σ</a> 
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            (

            <a href="references.html#Reference">Reference</a> (
            <a href="resourcelist.html">Any</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Problem resource
            <br/>  
          </td> 
        </tr> 
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
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            <span title="DetectedIssue.evidence : Supporting evidence or manifestations that provide the basis
             for identifying the detected issue such as a GuidanceResponse or MeasureReport.">evidence</span> 
            <a name="DetectedIssue.evidence"> </a>           </td>           <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="backboneelement.html">BackboneElement</a>           </td>           <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Supporting evidence
            <br/>            </td>         </tr>         <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <span title="DetectedIssue.evidence.code : A manifestation that led to the recording of this detected
             issue.">code</span> 
            <a name="DetectedIssue.evidence.code"> </a>           </td>           <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a>           </td>           <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Manifestation
            <br/>              <a href="valueset-manifestation-or-symptom.html" title="Codes that describes the types of evidence for a detected issue.">Manifestation and Symptom Codes</a>  (            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.">Example</a> )
            <br/>            </td>         </tr>         <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <span title="DetectedIssue.evidence.detail : Links to resources that constitute evidence for the detected
             issue such as a GuidanceResponse or MeasureReport.">detail</span> 
            <a name="DetectedIssue.evidence.detail"> </a>           </td>           <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (            <a href="resourcelist.html">Any</a> )          </td>           <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Supporting information
            <br/>            </td>         </tr>         <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            TRgwAAAABJRU5ErkJggg==" style="background-color: white; background-color: inherit" title="Primitive Data Type"/>  

            <span title="DetectedIssue.detail : A textual explanation of the detected issue.">detail</span> 
            <a name="DetectedIssue.detail"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#string">string</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Description and context</td> 
        </tr> 
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KG
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          sPVYVAgIJrA/sAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAR
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            TRgwAAAABJRU5ErkJggg==" style="background-color: white; background-color: inherit" title="Primitive Data Type"/>  

            <span title="DetectedIssue.reference : The literature, knowledge-base or similar reference that describes
             the propensity for the detected issue identified.">reference</span> 
            <a name="DetectedIssue.reference"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#uri">uri</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Authority for issue</td> 
        </tr> 
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KG
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAPQfAOvGUf7ztuvPMf/78/fkl/Pbg+u8Rvjqteu2Pf3zxPz36Pz0z+vTmPzurPvuw
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            5exg8Shl1ckRUQVaMVkQ2kCstKCEAOw==" style="background-color: white; background-color: inherit" title="Element"/>  

            <span title="DetectedIssue.mitigation : Indicates an action that has been taken or is committed to
             to reduce or eliminate the likelihood of the risk identified by the detected issue from
             manifesting.  Can also reflect an observation of known mitigating factors that may reduce/eliminate

             reduce or eliminate the likelihood of the risk identified by the detected issue from manifesting.
              Can also reflect an observation of known mitigating factors that may reduce/eliminate

             the need for any action.">mitigation</span> 
            <a name="DetectedIssue.mitigation"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="backboneelement.html">BackboneElement</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Step taken to address
            <br/>  
          </td> 
        </tr> 
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KG
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          VAgAJ//usAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAPZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk
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            f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///wD/ACH5BAEKAH8ALAAAAAAQABAAAAemgH+CgxeFF4OIhBdKGwFChYl/hY
            wbdkoBPnaQkosbG3d3VEpSUlonUoY1Gzo6QkI8SrGxWBOFG4uySgY5ZWR3PFy2hnaWZXC/PHcPwkpJk1ShoHcxhQEXSUmtFy6+0iS
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            <span title="DetectedIssue.mitigation.action : Describes the action that was taken or the observation
             that was made that reduces/eliminates the risk associated with the identified issue.">action</span> 
            <a name="DetectedIssue.mitigation.action"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">1..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">What mitigation?
            <br/>  
            <a href="valueset-detectedissue-mitigation-action.html" title="Codes describing steps taken to resolve the issue or other circumstances that mitigate
             the risk associated with the issue; e.g. 'added concurrent therapy', 'prior therapy documented',
             etc.">Detected Issue Mitigation Action</a>  (
            <a href="terminologies.html#preferred" title="Instances are encouraged to draw from the specified codes for interoperability purposes
             but are not required to do so to be considered conformant.">Preferred</a> )
          </td> 
        </tr> 
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KG
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> 
            data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAR
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            <span title="DetectedIssue.mitigation.date : Indicates when the mitigating action was documented.">date</span> 
            <a name="DetectedIssue.mitigation.date"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#dateTime">dateTime</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Date committed</td> 
        </tr> 
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KG
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          AASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
            3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw
            NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
            3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY
            FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
            3RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUO
            L+O8cJABttJM11/x1qZAGqRBEVcNIqdWj1efDqQbb3HwwwwEfABmQUHSPM9dtDAAAAAElFTkSuQmCC" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxj
            wv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjE
            EOACEIA/0o/38GGw+agoXYeNnDJDCUDnd/gkoFKhWozJiZI3gLwY6rAgxhsPKTPUzycTl8lAryMyMsVQG6TFi6cHULyz8KOjC7OIQ
            KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  
            <span title="DetectedIssue.mitigation.author : Identifies the practitioner who determined the mitigation
             and takes responsibility for the mitigation step occurring.">author</span> 
            <a name="DetectedIssue.mitigation.author"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            (
            )

            <a href="references.html#Reference">Reference</a> (
            <a href="practitioner.html">Practitioner</a>  | 
            <a href="practitionerrole.html">PractitionerRole</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Who is committing?</td> 
        </tr> 
        <tr> 
          <td class="hierarchy" colspan="5">
            <br/>  
            <a href="formats.html#table" title="Legend for this format">
              <img alt="doco" src="help16.png" style="background-color: inherit"/>  Documentation for this format
            </a> 
          </td> 
        </tr> 
      </table> 
    </div> 
  </text> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="trial-use"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="1"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category">
    <valueCode value="patient"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="cds"/> 
  </extension> 
  <url value="http://hl7.org/fhir/StructureDefinition/DetectedIssue"/> 
  <version value="4.1.0"/> 
  <name value="DetectedIssue"/> 
  <status value="draft"/> 
  

  <date value="2019-06-08T15:25:42+00:00"/> 
  <publisher value="Health Level Seven International (Clinical Decision Support)"/> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="http://hl7.org/fhir"/> 
    </telecom> 
  </contact> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="http://www.hl7.org/Special/committees/dss/index.cfm"/> 
    </telecom> 
  </contact> 
  
  

  <description value="Indicates an actual or potential clinical issue with or between one or more active or
   proposed clinical actions for a patient; e.g. Drug-drug interaction, Ineffective treatment
   frequency, Procedure-condition conflict, etc."/> 
  <fhirVersion value="4.1.0"/> 
  <mapping> 
    <identity value="workflow"/> 
    <uri value="http://hl7.org/fhir/workflow"/> 
    

    <name value="Workflow Pattern"/> 
  </mapping> 
  <mapping> 
    <identity value="v2"/> 
    <uri value="http://hl7.org/v2"/> 
    <name value="HL7 v2 Mapping"/> 
  </mapping> 
  <mapping> 
    <identity value="rim"/> 
    <uri value="http://hl7.org/v3"/> 
    <name value="RIM Mapping"/> 
  </mapping> 
  <mapping> 
    <identity value="w5"/> 
    
    

    <uri value="http://hl7.org/fhir/fivews"/> 
    <name value="FiveWs Pattern Mapping"/> 
  </mapping> 
  <kind value="resource"/> 
  <abstract value="false"/> 
  <type value="DetectedIssue"/> 
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
  <derivation value="specialization"/> 
  <snapshot> 
    <element id="DetectedIssue">
      <path value="DetectedIssue"/> 
      <short value="Clinical issue with action"/> 
      <definition value="Indicates an actual or potential clinical issue with or between one or more active or
       proposed clinical actions for a patient; e.g. Drug-drug interaction, Ineffective treatment
       frequency, Procedure-condition conflict, etc."/> 
      <alias value="DDI"/> 
      <alias value="drug-drug interaction"/> 
      <alias value="Contraindication"/> 
      <alias value="Alert"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DetectedIssue"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <constraint> 
        <key value="dom-2"/> 
        <severity value="error"/> 
        <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/> 
        <expression value="contained.contained.empty()"/> 
        <xpath value="not(parent::f:contained and f:contained)"/> 
        <source value="DomainResource"/> 
      </constraint> 
      <constraint> 
        
        
        
        
        
        
      
      

        <key value="dom-4"/> 
        <severity value="error"/> 
        <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or
         a meta.lastUpdated"/> 
        <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/> 
        <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/> 
        <source value="DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-3"/> 
        <severity value="error"/> 
        <human value="If the resource is contained in another resource, it SHALL be referred to from elsewhere
         in the resource
        
        not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f
        :reference/@value=concat('#', $id))]))

         in the resource or SHALL refer to the containing resource"/> 
        <expression value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonica
        l) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(refer
        ence = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(c
        anonical) = '#').exists()).not()).trace('unmatched', id).empty()"/> 
        <xpath value="not(exists(for $contained in f:contained return $contained[not(parent::*/descendant::f:reference/@va
        lue=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))"/> 
        <source value="DomainResource"/>       </constraint>       <constraint>         <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">          <valueBoolean value="true"/>         </extension>         <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">          <valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display
           the resource to a human safely. Including a human readable representation in the resource
           makes for a much more robust eco-system and cheaper handling of resources by intermediary
           systems. Some ecosystems restrict distribution of resources to only those systems that
           do fully understand the resources, and as a consequence implementers may believe that
           the narrative is superfluous. However experience shows that such eco-systems often open
           up to new participants over time."/> 
        </extension>         <key value="dom-6"/>         <severity value="warning"/>         <human value="A resource should have narrative for robust management"/>         <expression value="text.div.exists()"/>         <xpath value="exists(f:text/h:div)"/> 
        <source value="DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-5"/> 
        <severity value="error"/> 
        <human value="If a resource is contained in another resource, it SHALL NOT have a security label"/> 
        <expression value="contained.meta.security.empty()"/> 
        <xpath value="not(exists(f:contained/*/f:meta/f:security))"/> 
        <source value="DomainResource"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Entity. Role, or Act"/> 
      </mapping> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="Partial mapping from messages containing the AL1 or IAM segment, such as the ADT^A01,
         ADT^A08, and ADT^A60."/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Observation[classCode=ALRT, moodCode=EVN)"/> 
      </mapping> 
      
        
        
      

    </element> 
    <element id="DetectedIssue.id">
      <path value="DetectedIssue.id"/> 
      <short value="Logical id of this artifact"/> 
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this
       value never changes."/> 
      <comment value="The only time that a resource does not have an id is when it is being submitted to the
       server using a create operation."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="id"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="DetectedIssue.meta">
      <path value="DetectedIssue.meta"/> 
      <short value="Metadata about the resource"/> 
      <definition value="The metadata about the resource. This is content that is maintained by the infrastructure.
       Changes to the content may not always be associated with version changes to the resource.

       Changes to the content might not always be associated with version changes to the resource."/> 

      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.meta"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Meta"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="DetectedIssue.implicitRules">
      <path value="DetectedIssue.implicitRules"/> 
      <short value="A set of rules under which this content was created"/> 
      <definition value="A reference to a set of rules that were followed when the resource was constructed, and
       which must be understood when processing the content.

       which must be understood when processing the content. Often, this is a reference to an
       implementation guide that defines the special rules along with other profiles etc."/> 

      <comment value="Asserting this rule set restricts the content to be only understood by a limited set of
       trading partners. This inherently limits the usefulness of the data in the long term.
       However, the existing health eco-system is highly fractured, and not yet ready to define,
       collect, and exchange data in a generally computable sense. Wherever possible, implementers
       and/or specification writers should avoid using this element. 
This element is labelled as a modifier because the implicit rules may provide additional
       knowledge about the resource that modifies it's meaning or interpretation.

       and/or specification writers should avoid using this element. Often, when used, the URL
       is a reference to an implementation guide that defines these special rules as part of
       it's narrative along with other profiles, value sets, etc."/> 

      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.implicitRules"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <isModifier value="true"/> 
      <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional
       knowledge about the resource that modifies it's meaning or interpretation"/> 

      <isSummary value="true"/> 
    </element> 
    <element id="DetectedIssue.language">
      <path value="DetectedIssue.language"/> 
      <short value="Language of the resource content"/> 
      <definition value="The base language in which the resource is written."/> 
      <comment value="Language is provided to support indexing and accessibility (typically, services such as
       text to speech use the language tag). The html language tag in the narrative applies 
       to the narrative. The language tag on the resource may be used to specify the language
       of other presentations generated from the data in the resource  Not all the content has

       of other presentations generated from the data in the resource. Not all the content has

       to be in the base language. The Resource.language should not be assumed to apply to the
       narrative automatically. If a language is specified, it should it also be specified on
       the div element in the html (see rules in HTML5 for information about the relationship
       between xml:lang and the html lang attribute)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.language"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          
            
          

          <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        

        <strength value="preferred"/> 
        <description value="A human language."/> 
        
          
        

        <valueSet value="http://hl7.org/fhir/ValueSet/languages"/> 
      </binding> 
    </element> 
    <element id="DetectedIssue.text">
      <path value="DetectedIssue.text"/> 
      <short value="Text summary of the resource, for human interpretation"/> 
      A human-readable narrative that contains a summary of the resource, and may be used to

      <definition value="A human-readable narrative that contains a summary of the resource and can be used to
       represent the content of the resource to a human. The narrative need not encode all the
       structured data, but is required to contain sufficient detail to make it &quot;clinically
       safe&quot; for a human to just read the narrative. Resource definitions may define what
       content should be represented in the narrative to ensure clinical safety."/> 
      <comment value="Contained resources do not have narrative. Resources that are not contained SHOULD have
       a narrative. In some cases, a resource may only have text with little or no additional
       discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary
       for data from legacy systems where information is captured as a &quot;text blob&quot;
       or where text is additionally entered raw or narrated and encoded in formation is added

       or where text is additionally entered raw or narrated and encoded information is added

       later."/> 
      <alias value="narrative"/> 
      <alias value="html"/> 
      <alias value="xhtml"/> 
      <alias value="display"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DomainResource.text"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Narrative"/> 
      </type> 
      

      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Act.text?"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.contained">
      <path value="DetectedIssue.contained"/> 
      <short value="Contained, inline Resources"/> 
      <definition value="These resources do not have an independent existence apart from the resource that contains
       them - they cannot be identified independently, and nor can they have their own independent
       transaction scope."/> 
      <comment value="This should never be done when the content can be identified properly, as once identification
       is lost, it is extremely difficult (and context dependent) to restore it again.

       is lost, it is extremely difficult (and context dependent) to restore it again. Contained
       resources may have profiles and tags In their meta elements, but SHALL NOT have security
       labels."/> 

      <alias value="inline resources"/> 
      <alias value="anonymous resources"/> 
      <alias value="contained resources"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.contained"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Resource"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.extension">
      <path value="DetectedIssue.extension"/> 
      

      <short value="Additional content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource. In order to make the use of extensions safe and manageable, there is
       a strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension.

       of the resource. To make the use of extensions safe and manageable, there is a strict
       set of governance  applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part of the
       definition of the extension."/> 

      <comment value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.modifierExtension">
      <path value="DetectedIssue.modifierExtension"/> 
      <short value="Extensions that cannot be ignored"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource, and that modifies the understanding of the element that contains it.
       Usually modifier elements provide negation or qualification. In order to make the use
       of extensions safe and manageable, there is a strict set of governance applied to the
       definition and use of extensions. Though any implementer is allowed to define an extension,
       there is a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions.

       of the resource and that modifies the understanding of the element that contains it and/or
       the understanding of the containing element's descendants. Usually modifier elements provide
       negation or qualification. To make the use of extensions safe and manageable, there is
       a strict set of governance applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension. Applications processing a resource
       are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource
       (including cannot change the meaning of modifierExtension itself)."/> 

      <comment value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly
       distinguished from the vast majority of extensions which can be safely ignored.  This
       promotes interoperability by eliminating the need for implementers to prohibit the presence
       of extensions. For further information, see the [definition of modifier extensions](extensibility.ht
      ml#modifierExtension)."/> 

      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource
       that contains them"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.identifier">
      <path value="DetectedIssue.identifier"/> 
      <short value="Unique id for the detected issue"/> 
      <definition value="Business identifier associated with the detected issue record."/> 
      <requirements value="Allows linking instances of the same detected issue found on different servers."/> 
      <min value="0"/> 
      

      <max value="*"/> 
      <base> 
        <path value="DetectedIssue.identifier"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Identifier"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="IAM-7"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".id"/> 
      </mapping> 
      
        
        
      

    </element> 
    <element id="DetectedIssue.status">
      <path value="DetectedIssue.status"/> 
      <short value="registered | preliminary | final | amended +"/> 
      <definition value="Indicates the status of the detected issue."/> 
      <comment value="This element is labeled as a modifier because the status contains the codes cancelled
       and entered-in-error that mark the issue as not currently valid."/> 
      <alias value="status"/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="DetectedIssue.status"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <isModifier value="true"/> 
      <isModifierReason value="This element is labeled as a modifier because it is a status element that contains status
       entered-in-error which means that the resource should not be treated as valid"/> 

      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DetectedIssueStatus"/> 
        </extension> 
        <strength value="required"/> 
        
        
          
        

        <description value="Indicates the status of the identified issue."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/observation-status|4.1.0"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.status"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        

        <map value="FiveWs.status"/> 
      </mapping> 
    </element> 
    
      

    <element id="DetectedIssue.code">
      <path value="DetectedIssue.code"/> 
      <short value="Issue Category, e.g. drug-drug, duplicate therapy, etc."/> 
      <definition value="Identifies the general type of issue identified."/> 
      <alias value="type"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DetectedIssue.code"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DetectedIssueCategory"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="Codes identifying the general type of detected issue; e.g. Drug-drug interaction, Timing
         issue, Duplicate therapy, etc."/> 
        
          
        

        <valueSet value="http://hl7.org/fhir/ValueSet/detectedissue-category"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.code"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.class"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="AL1-2 / IAM-9"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
      
        
        
      

    </element> 
    <element id="DetectedIssue.severity">
      <path value="DetectedIssue.severity"/> 
      <short value="high | moderate | low"/> 
      <definition value="Indicates the degree of importance associated with the identified issue based on the potential
       impact on the patient."/> 
      <alias value="severity"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DetectedIssue.severity"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DetectedIssueSeverity"/> 
        </extension> 
        <strength value="required"/> 
        <description value="Indicates the potential degree of impact of the identified issue on the patient."/> 
        
          
        

        <valueSet value="http://hl7.org/fhir/ValueSet/detectedissue-severity|4.1.0"/> 
      </binding> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.grade"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="AL1-4/ IAR-2"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV].value"/> 
      </mapping> 
      
        
        
      

    </element> 
    <element id="DetectedIssue.patient">
      <path value="DetectedIssue.patient"/> 
      <short value="Associated patient"/> 
      <definition value="Indicates the patient whose record the detected issue is associated with."/> 
      <requirements value="While the subject could be inferred by tracing the subject of the implicated resources,
       it's useful to have a direct link for query purposes."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DetectedIssue.patient"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.subject"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="PID-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=SBJ].role[classCode=PAT]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        

        <map value="FiveWs.subject"/> 
      </mapping> 
    </element> 
    
      

    <element id="DetectedIssue.identified[x]">
      <path value="DetectedIssue.identified[x]"/> 
      <short value="When identified"/> 
      

      <definition value="The date or period when the detected issue was initially identified."/> 
      <requirements value="No-one can be responsible for mitigation prior to the issue being identified."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DetectedIssue.identified[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <type> 
        <code value="Period"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        

        <map value="Event.occurrence[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.recorded"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="ALI-6 / IAM-11"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".effectiveTime"/> 
      </mapping> 
      
        
        
      

    </element> 
    <element id="DetectedIssue.author">
      <path value="DetectedIssue.author"/> 
      <short value="The provider or device that identified the issue"/> 
      <definition value="Individual or device responsible for the issue being raised.  For example, a decision
       support application or a pharmacist conducting a medication review."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DetectedIssue.author"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
      
      
        

        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.performer.actor"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.author"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="IAM-14 / IAM-16"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT].role[classCode=ASSIGNED]"/> 
      </mapping> 
      
        
        
      

    </element> 
    <element id="DetectedIssue.implicated">
      <path value="DetectedIssue.implicated"/> 
      <short value="Problem resource"/> 
      <definition value="Indicates the resource representing the current activity or proposed activity that is
       potentially problematic."/> 
      <comment value="There's an implicit constraint on the number of implicated resources based on DetectedIssue.type;
       e.g. For drug-drug, there would be more than one.  For timing, there would typically only
       be one."/> 
      <alias value="cause"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DetectedIssue.implicated"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.reasonReference"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=SUBJ].target[moodCode=EVN, INT]"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.evidence">
      <path value="DetectedIssue.evidence"/> 
      <short value="Supporting evidence"/> 
      <definition value="Supporting evidence or manifestations that provide the basis for identifying the detected
       issue such as a GuidanceResponse or MeasureReport."/> 
      <min value="0"/>       <max value="*"/>       <base>         <path value="DetectedIssue.evidence"/>         <min value="0"/>         <max value="*"/>       </base>       <type>         <code value="BackboneElement"/>       </type>       <constraint>         <key value="ele-1"/>         <severity value="error"/>         <human value="All FHIR elements must have a @value or children"/>         <expression value="hasValue() or (children().count() &gt; id.count())"/>         <xpath value="@value|f:*|h:div"/>         <source value="Element"/>       </constraint>       <isModifier value="false"/>       <isSummary value="false"/>       <mapping>         <identity value="w5"/>         <map value="FiveWs.why[x]"/>       </mapping>     </element>     <element id="DetectedIssue.evidence.id">      <path value="DetectedIssue.evidence.id"/>       <representation value="xmlAttr"/>       <short value="Unique id for inter-element referencing"/>       <definition value="Unique id for the element within a resource (for internal references). This may be any
       string value that does not contain spaces."/> 
      <min value="0"/>       <max value="1"/>       <base>         <path value="Element.id"/>         <min value="0"/>         <max value="1"/>       </base>       <type>         <code value="string"/>       </type>       <isModifier value="false"/>       <isSummary value="false"/>       <mapping>         <identity value="rim"/>         <map value="n/a"/>       </mapping>     </element>     <element id="DetectedIssue.evidence.extension">      <path value="DetectedIssue.evidence.extension"/>       <short value="Additional content defined by implementations"/>       <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. To make the use of extensions safe and manageable, there is a strict set
       of governance  applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part of the
       definition of the extension."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/> 
      <alias value="extensions"/>       <alias value="user content"/>       <min value="0"/>       <max value="*"/>       <base>         <path value="Element.extension"/>         <min value="0"/>         <max value="*"/>       </base>       <type>         <code value="Extension"/>       </type>       <isModifier value="false"/>       <isSummary value="false"/>       <mapping>         <identity value="rim"/>         <map value="n/a"/>       </mapping>     </element>     <element id="DetectedIssue.evidence.modifierExtension">      <path value="DetectedIssue.evidence.modifierExtension"/>       <short value="Extensions that cannot be ignored even if unrecognized"/>       <definition value="May be used to represent additional information that is not part of the basic definition
       of the element and that modifies the understanding of the element in which it is contained
       and/or the understanding of the containing element's descendants. Usually modifier elements
       provide negation or qualification. To make the use of extensions safe and manageable,
       there is a strict set of governance applied to the definition and use of extensions. Though
       any implementer can define an extension, there is a set of requirements that SHALL be
       met as part of the definition of the extension. Applications processing a resource are
       required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource
       (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly
       distinguished from the vast majority of extensions which can be safely ignored.  This
       promotes interoperability by eliminating the need for implementers to prohibit the presence
       of extensions. For further information, see the [definition of modifier extensions](extensibility.ht
      ml#modifierExtension)."/> 
      <alias value="extensions"/>       <alias value="user content"/>       <alias value="modifiers"/>       <min value="0"/>       <max value="*"/>       <base>         <path value="BackboneElement.modifierExtension"/>         <min value="0"/>         <max value="*"/>       </base>       <type>         <code value="Extension"/>       </type>       <isModifier value="true"/>       <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element
       that contains them"/> 
      <isSummary value="true"/>       <mapping>         <identity value="rim"/>         <map value="N/A"/>       </mapping>     </element>     <element id="DetectedIssue.evidence.code">      <path value="DetectedIssue.evidence.code"/>       <short value="Manifestation"/>       <definition value="A manifestation that led to the recording of this detected issue."/>       <min value="0"/>       <max value="*"/>       <base>         <path value="DetectedIssue.evidence.code"/>         <min value="0"/>         <max value="*"/>       </base>       <type>         <code value="CodeableConcept"/>       </type>       <isModifier value="false"/>       <isSummary value="false"/>       <binding>         <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">          <valueString value="DetectedIssueEvidenceCode"/>         </extension>         <strength value="example"/>         <description value="Codes that describes the types of evidence for a detected issue."/>         <valueSet value="http://hl7.org/fhir/ValueSet/manifestation-or-symptom"/>       </binding>       <mapping>         <identity value="w5"/>         <map value="FiveWs.why[x]"/>       </mapping>     </element>     <element id="DetectedIssue.evidence.detail">      <path value="DetectedIssue.evidence.detail"/>       <short value="Supporting information"/>       <definition value="Links to resources that constitute evidence for the detected issue such as a GuidanceResponse
       or MeasureReport."/> 
      <min value="0"/>       <max value="*"/>       <base>         <path value="DetectedIssue.evidence.detail"/>         <min value="0"/>         <max value="*"/>       </base>       <type>         <code value="Reference"/>         <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/>       </type>       <isModifier value="false"/>       <isSummary value="false"/>       <mapping>         <identity value="w5"/>         <map value="FiveWs.why[x]"/>       </mapping>     </element> 
    <element id="DetectedIssue.detail">
      <path value="DetectedIssue.detail"/> 
      <short value="Description and context"/> 
      <definition value="A textual explanation of the detected issue."/> 
      <comment value="Should focus on information not covered elsewhere as discrete data - no need to duplicate
       the narrative."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DetectedIssue.detail"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.note"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="AL1-5 / IAM-8"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".text"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.reference">
      <path value="DetectedIssue.reference"/> 
      <short value="Authority for issue"/> 
      <definition value="The literature, knowledge-base or similar reference that describes the propensity for
       the detected issue identified."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DetectedIssue.reference"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=INST].target[classCode=ALRT, moodCode=DEFN].text.uri"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.mitigation">
      <path value="DetectedIssue.mitigation"/> 
      <short value="Step taken to address"/> 
      Indicates an action that has been taken or is committed to to reduce or eliminate the
       likelihood of the risk identified by the detected issue from manifesting.  Can also reflect
       an observation of known mitigating factors that may reduce/eliminate the need for any
       action.

      <definition value="Indicates an action that has been taken or is committed to reduce or eliminate the likelihood
       of the risk identified by the detected issue from manifesting.  Can also reflect an observation
       of known mitigating factors that may reduce/eliminate the need for any action."/> 

      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DetectedIssue.mitigation"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        

        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=MITG].target[classCode=ACT, moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.mitigation.id">
      <path value="DetectedIssue.mitigation.id"/> 
      <representation value="xmlAttr"/> 
      
      unique id for the element within a resource (for internal references). This may be any

      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may be any
       string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.mitigation.extension">
      <path value="DetectedIssue.mitigation.extension"/> 
      

      <short value="Additional content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension.

       of the element. To make the use of extensions safe and manageable, there is a strict set
       of governance  applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part of the
       definition of the extension."/> 

      <comment value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.mitigation.modifierExtension">
      <path value="DetectedIssue.mitigation.modifierExtension"/> 
      

      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element, and that modifies the understanding of the element that contains it. Usually
       modifier elements provide negation or qualification. In order to make the use of extensions
       safe and manageable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension. Applications
       processing a resource are required to check for modifier extensions.

       of the element and that modifies the understanding of the element in which it is contained
       and/or the understanding of the containing element's descendants. Usually modifier elements
       provide negation or qualification. To make the use of extensions safe and manageable,
       there is a strict set of governance applied to the definition and use of extensions. Though
       any implementer can define an extension, there is a set of requirements that SHALL be
       met as part of the definition of the extension. Applications processing a resource are
       required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource
       (including cannot change the meaning of modifierExtension itself)."/> 

      <comment value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly
       distinguished from the vast majority of extensions which can be safely ignored.  This
       promotes interoperability by eliminating the need for implementers to prohibit the presence
       of extensions. For further information, see the [definition of modifier extensions](extensibility.ht
      ml#modifierExtension)."/> 

      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element
       that contains them"/> 

      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.mitigation.action">
      <path value="DetectedIssue.mitigation.action"/> 
      <short value="What mitigation?"/> 
      <definition value="Describes the action that was taken or the observation that was made that reduces/eliminates
       the risk associated with the identified issue."/> 
      <comment value="The &quot;text&quot; component can be used for detail or when no appropriate code exists."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="DetectedIssue.mitigation.action"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DetectedIssueMitigationAction"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="Codes describing steps taken to resolve the issue or other circumstances that mitigate
         the risk associated with the issue; e.g. 'added concurrent therapy', 'prior therapy documented',
         etc."/> 
        
          
        

        <valueSet value="http://hl7.org/fhir/ValueSet/detectedissue-mitigation-action"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.mitigation.date">
      <path value="DetectedIssue.mitigation.date"/> 
      <short value="Date committed"/> 
      <definition value="Indicates when the mitigating action was documented."/> 
      

      <comment value="This might not be the same as when the mitigating step was actually taken."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DetectedIssue.mitigation.date"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".effectiveTime"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.mitigation.author">
      <path value="DetectedIssue.mitigation.author"/> 
      <short value="Who is committing?"/> 
      <definition value="Identifies the practitioner who determined the mitigation and takes responsibility for
       the mitigation step occurring."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DetectedIssue.mitigation.author"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT].role[classCode=ASSIGNED]"/> 
      </mapping> 
    </element> 
  </snapshot> 
  <differential> 
    <element id="DetectedIssue">
      <path value="DetectedIssue"/> 
      <short value="Clinical issue with action"/> 
      <definition value="Indicates an actual or potential clinical issue with or between one or more active or
       proposed clinical actions for a patient; e.g. Drug-drug interaction, Ineffective treatment
       frequency, Procedure-condition conflict, etc."/> 
      <alias value="DDI"/> 
      <alias value="drug-drug interaction"/> 
      <alias value="Contraindication"/> 
      <alias value="Alert"/> 
      <min value="0"/> 
      <max value="*"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="Partial mapping from messages containing the AL1 or IAM segment, such as the ADT^A01,
         ADT^A08, and ADT^A60."/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Observation[classCode=ALRT, moodCode=EVN)"/> 
      </mapping> 
      
        
        
      

    </element> 
    <element id="DetectedIssue.identifier">
      <path value="DetectedIssue.identifier"/> 
      <short value="Unique id for the detected issue"/> 
      <definition value="Business identifier associated with the detected issue record."/> 
      <requirements value="Allows linking instances of the same detected issue found on different servers."/> 
      <min value="0"/> 
      

      <max value="*"/> 
      <type> 
        <code value="Identifier"/> 
      </type> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="IAM-7"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".id"/> 
      </mapping> 
      
        
        
      

    </element> 
    <element id="DetectedIssue.status">
      <path value="DetectedIssue.status"/> 
      <short value="registered | preliminary | final | amended +"/> 
      <definition value="Indicates the status of the detected issue."/> 
      <comment value="This element is labeled as a modifier because the status contains the codes cancelled
       and entered-in-error that mark the issue as not currently valid."/> 
      <alias value="status"/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="code"/> 
      </type> 
      <isModifier value="true"/> 
      <isModifierReason value="This element is labeled as a modifier because it is a status element that contains status
       entered-in-error which means that the resource should not be treated as valid"/> 

      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DetectedIssueStatus"/> 
        </extension> 
        <strength value="required"/> 
        
        
          
        

        <description value="Indicates the status of the identified issue."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/observation-status|4.1.0"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.status"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        

        <map value="FiveWs.status"/> 
      </mapping> 
    </element> 
    
      

    <element id="DetectedIssue.code">
      <path value="DetectedIssue.code"/> 
      <short value="Issue Category, e.g. drug-drug, duplicate therapy, etc."/> 
      <definition value="Identifies the general type of issue identified."/> 
      <alias value="type"/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DetectedIssueCategory"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="Codes identifying the general type of detected issue; e.g. Drug-drug interaction, Timing
         issue, Duplicate therapy, etc."/> 
        
          
        

        <valueSet value="http://hl7.org/fhir/ValueSet/detectedissue-category"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.code"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.class"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="AL1-2 / IAM-9"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
      
        
        
      

    </element> 
    <element id="DetectedIssue.severity">
      <path value="DetectedIssue.severity"/> 
      <short value="high | moderate | low"/> 
      <definition value="Indicates the degree of importance associated with the identified issue based on the potential
       impact on the patient."/> 
      <alias value="severity"/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="code"/> 
      </type> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DetectedIssueSeverity"/> 
        </extension> 
        <strength value="required"/> 
        <description value="Indicates the potential degree of impact of the identified issue on the patient."/> 
        
          
        

        <valueSet value="http://hl7.org/fhir/ValueSet/detectedissue-severity|4.1.0"/> 
      </binding> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.grade"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="AL1-4/ IAR-2"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV].value"/> 
      </mapping> 
      
        
        
      

    </element> 
    <element id="DetectedIssue.patient">
      <path value="DetectedIssue.patient"/> 
      <short value="Associated patient"/> 
      <definition value="Indicates the patient whose record the detected issue is associated with."/> 
      <requirements value="While the subject could be inferred by tracing the subject of the implicated resources,
       it's useful to have a direct link for query purposes."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
      </type> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.subject"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="PID-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=SBJ].role[classCode=PAT]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        

        <map value="FiveWs.subject"/> 
      </mapping> 
    </element> 
    
      

    <element id="DetectedIssue.identified[x]">
      <path value="DetectedIssue.identified[x]"/> 
      <short value="When identified"/> 
      

      <definition value="The date or period when the detected issue was initially identified."/> 
      <requirements value="No-one can be responsible for mitigation prior to the issue being identified."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <type> 
        <code value="Period"/> 
      </type> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        

        <map value="Event.occurrence[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.recorded"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="ALI-6 / IAM-11"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".effectiveTime"/> 
      </mapping> 
      
        
        
      

    </element> 
    <element id="DetectedIssue.author">
      <path value="DetectedIssue.author"/> 
      <short value="The provider or device that identified the issue"/> 
      <definition value="Individual or device responsible for the issue being raised.  For example, a decision
       support application or a pharmacist conducting a medication review."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
      
      
        

        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/> 
      </type> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.performer.actor"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.author"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="IAM-14 / IAM-16"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT].role[classCode=ASSIGNED]"/> 
      </mapping> 
      
        
        
      

    </element> 
    <element id="DetectedIssue.implicated">
      <path value="DetectedIssue.implicated"/> 
      <short value="Problem resource"/> 
      <definition value="Indicates the resource representing the current activity or proposed activity that is
       potentially problematic."/> 
      <comment value="There's an implicit constraint on the number of implicated resources based on DetectedIssue.type;
       e.g. For drug-drug, there would be more than one.  For timing, there would typically only
       be one."/> 
      <alias value="cause"/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.reasonReference"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=SUBJ].target[moodCode=EVN, INT]"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.evidence">
      <path value="DetectedIssue.evidence"/> 
      <short value="Supporting evidence"/> 
      <definition value="Supporting evidence or manifestations that provide the basis for identifying the detected
       issue such as a GuidanceResponse or MeasureReport."/> 
      <min value="0"/>       <max value="*"/>       <type>         <code value="BackboneElement"/>       </type>       <mapping>         <identity value="w5"/>         <map value="FiveWs.why[x]"/>       </mapping>     </element>     <element id="DetectedIssue.evidence.code">      <path value="DetectedIssue.evidence.code"/>       <short value="Manifestation"/>       <definition value="A manifestation that led to the recording of this detected issue."/>       <min value="0"/>       <max value="*"/>       <type>         <code value="CodeableConcept"/>       </type>       <binding>         <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">          <valueString value="DetectedIssueEvidenceCode"/>         </extension>         <strength value="example"/>         <description value="Codes that describes the types of evidence for a detected issue."/>         <valueSet value="http://hl7.org/fhir/ValueSet/manifestation-or-symptom"/>       </binding>       <mapping>         <identity value="w5"/>         <map value="FiveWs.why[x]"/>       </mapping>     </element>     <element id="DetectedIssue.evidence.detail">      <path value="DetectedIssue.evidence.detail"/>       <short value="Supporting information"/>       <definition value="Links to resources that constitute evidence for the detected issue such as a GuidanceResponse
       or MeasureReport."/> 
      <min value="0"/>       <max value="*"/>       <type>         <code value="Reference"/>         <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/>       </type>       <mapping>         <identity value="w5"/>         <map value="FiveWs.why[x]"/>       </mapping>     </element> 
    <element id="DetectedIssue.detail">
      <path value="DetectedIssue.detail"/> 
      <short value="Description and context"/> 
      <definition value="A textual explanation of the detected issue."/> 
      <comment value="Should focus on information not covered elsewhere as discrete data - no need to duplicate
       the narrative."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="string"/> 
      </type> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.note"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="AL1-5 / IAM-8"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".text"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.reference">
      <path value="DetectedIssue.reference"/> 
      <short value="Authority for issue"/> 
      <definition value="The literature, knowledge-base or similar reference that describes the propensity for
       the detected issue identified."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="uri"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=INST].target[classCode=ALRT, moodCode=DEFN].text.uri"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.mitigation">
      <path value="DetectedIssue.mitigation"/> 
      <short value="Step taken to address"/> 
      Indicates an action that has been taken or is committed to to reduce or eliminate the
       likelihood of the risk identified by the detected issue from manifesting.  Can also reflect
       an observation of known mitigating factors that may reduce/eliminate the need for any
       action.

      <definition value="Indicates an action that has been taken or is committed to reduce or eliminate the likelihood
       of the risk identified by the detected issue from manifesting.  Can also reflect an observation
       of known mitigating factors that may reduce/eliminate the need for any action."/> 

      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=MITG].target[classCode=ACT, moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.mitigation.action">
      <path value="DetectedIssue.mitigation.action"/> 
      <short value="What mitigation?"/> 
      <definition value="Describes the action that was taken or the observation that was made that reduces/eliminates
       the risk associated with the identified issue."/> 
      <comment value="The &quot;text&quot; component can be used for detail or when no appropriate code exists."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DetectedIssueMitigationAction"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="Codes describing steps taken to resolve the issue or other circumstances that mitigate
         the risk associated with the issue; e.g. 'added concurrent therapy', 'prior therapy documented',
         etc."/> 
        
          
        

        <valueSet value="http://hl7.org/fhir/ValueSet/detectedissue-mitigation-action"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.mitigation.date">
      <path value="DetectedIssue.mitigation.date"/> 
      <short value="Date committed"/> 
      <definition value="Indicates when the mitigating action was documented."/> 
      

      <comment value="This might not be the same as when the mitigating step was actually taken."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".effectiveTime"/> 
      </mapping> 
    </element> 
    <element id="DetectedIssue.mitigation.author">
      <path value="DetectedIssue.mitigation.author"/> 
      <short value="Who is committing?"/> 
      <definition value="Identifies the practitioner who determined the mitigation and takes responsibility for
       the mitigation step occurring."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT].role[classCode=ASSIGNED]"/> 
      </mapping> 
    </element> 
  </differential> 


</

StructureDefinition

>



Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.