Wednesday, January 22, 2020

A Brief Reflection on 3 decades of interoperability at The IHE USA Connectathon conference


My bit from the IHE Connectathon conference today in summary:

What do we want? We want our data.  When do we want it?  Yesterday.  We’re now entering our third decade into attention on interoperability in healthcare. Hopefully, it’s not same stuff, different decade (SSDD). In the naughts, we focused on what we aught to do ... build interoperable systems.  In the teens, we focused on interoperability in the betweens, between providers, and to some extent between providers and patients.  In the twenties, my hope is that we focus on what our want is...

What have we learned over the last two decades?  We need standards, multiple standards, to support interoperability [standards are like potato chips, you cannot just have one].  Standards are essential.  Good standards make it easy for smart people to create interoperable solutions.  What we actually need are GREAT standards, because great standards make it possible for ANYONE to interoperate.

Tuesday, January 21, 2020

Querying with Dates in FHIR, date to dateTime

Oh, the vagaries of time .. and date .. and time zones.  What does it mean to query by date when there is a timestamp?

FHIR has this to say:
Where possible, the system should correct for time zones when performing queries. Dates do not have time zones, and time zones should not be considered. Where both search parameters and resource element date times do not have time zones, the servers local time zone should be assumed.
I find this unhelpful without a lot more thought.

What happens (or should happen) when you compare a date (in your query) to a dateTime in a resource?

Consider a dateTime for birth: January 20th, 1965, at 3:30am EST.  Assume this is stored in the Patient resource, and except for the hour (which I changed to explain the problem), this is my birth date.

Now, query for date of birth using 1965-01-20.  This is a whole day.  If I perform the query using Unix Epoch times, this day started in EDT at -156106800, and ended at -156020401.  But in UTC it starts on -156124800 and ends at -156038401.  And in AKST (Alaska), it's different again.

The same time in Alaska is 4 hours earlier than it is in Boston, and which is another 5 hours earlier than the time London.  So, what how do I compare the date?

Let's say I had an evil twin brother from another mother born in Alaska the same time as I was born in Philadelphia.  Well, his birth date is a day before mine.  He's evil because he got to get his driver's permit a day before I got mine ... and birthday presents a day earlier, and a bunch of other stuff I didn't get.

But we were born at the exact same time.  So if I query a FHIR server that has both our patient records for fhir/Patient?birthdate=eq1965-01-20, should his record also appear?

My answer to this question is NO, b/c according to his record, it says: "birthDate": "1965-01-19T23:30:00-09:00", and mine says "1965-01-20T03:30:00-05:00".

So, how does one turn the query parameter 1965-01-20 into an appropriate value to probe for these records, and how does one turn our dates of birth into appropriate values in an index in order to query these correctly?  I had originally thought to use the querant's time zone as part of the answer, but then you get different answers to the question based on where the querant is at the time (and since I travel quite a bit, I know how confusing that would be), or based on where the system the querant is using at the time (which may not be anywhere near where they are located ... consider someone like Graham Grieve updating the HL7 site stored on AWS servers in the US from Australia).

The answer is fairly straightforward, but not obvious.  A date and a dateTime are similar, but not identical data types.  The full state of a dateTime is captured in the date, time, precision, and time zone information. While the same information can capture the full state of a date, all you need is date, and precision because time and timezone don't matter.  And since two different dateTimes can resolve to different dates, they are different species of data (same genus, but one has some extra genes as it were).

That means that to index a DateTime or Instant, you need to capture the date alone in one index field, and the timestamp (with or without timezone) in another.  Only in this way can you correctly do comparisons between date (in the query) and dateTime (in the resource).  And if you do it this way, you will find me, and not my evil twin.

When the queried value is to the day or less, compare against the date field.  When more precise, compare against the dateTime field.

Later this week, I'll take up the other direction.  Is 1965-01-20 greater, less than, or equal to 1965-01-20T03:30:00-05:00?  What about 1965-01-19T23:30:00-09:00?
————
Thanks to Ryan Moehrke (yes, he’s John’s son) for the correction on my time stamps.


Sunday, December 29, 2019

4am Rant

Gads, I don't even know where to start.  A young person living in my home (my eldest's fiance) has just spend something like 17 hours in an ED hallway, 12 of them waiting for an inpatient or observation bed. They've been suffering from seizures of unknown origin (though possibly related to their not-quite-fully diagnosed or treated hyper-mobility disorder).  A neuro-consult from that facility was impossible to get w/o an order or referral, which apparently wasn't provided when they left another ED six days ago when they were first seen for these episodes.  And so they scheduled an urgent visit with their primary care, and had another seizure during that visit, which prompted an ambulance ride to the ED attached to the hospital they need a consult with.

Evaluation took about four hours, not bad considering prior experiences, and a decision to admit for observation, appropriate testing, et cetera was made.  But no beds are available in that unit.  Nor in the ED.  After three promised beds had been given to others (I won't argue others don't need them more, I will argue that the process is broken when it causes three broken promises), and the planned test is now scheduled 23 hours from now (at 4am in the morning), it was time for me to make a phone call.  The ED nurse had the gall to complain about the "inappropriateness of my calling" in front of my eldest and the patient.  I made a very polite call and requested to speak to the patient's attending.  If there was inappropriateness, it was on behalf of the arguably overworked nurse.

I made the call because we want to understand the risk of simply going home at this stage, and the chances of getting a bed in the next eight hours.  At this stage, the psychological health of their patient is in the toilet, the hospital cannot keep up with their med regimen, or treat pain, causing further distress.  The noise, blaring music, and bright lights make it impossible to sleep.

The need for a workup is sufficiently serious to make it worth a 24-hour wait in a hallway.  Six days of seizures is five too many.  But the other impacts on the patient's health given the conditions, lack of care and ongoing delays are sufficiently concerning to make it necessary to make a decision about the right way to achieve appropriate diagnosis (we have yet to even know what to do about treatment).  Think about that, how would you feel about having seizures that leave you unable to move for hours afterwards (NOT too-tired, rather, UNABLE to move, the limbs simply don't work, don't respond to stimulus, the nerves aren't working).  Day after day?  And have to wait for diagnosis...

Being sick through the holidays sucks. I have great respect for the medical professionals who work through the holidays.  But I also understand who most often gets stuck with those shifts.  And as a patient (or the patient's advocate), it's no damn fun at all.

What would you do in this situation?






Thursday, November 7, 2019

ACID, BASE, HATEOAS and Pagination in HAPI on FHIR

Let's start with some definitions:
Two common transaction models are ACID and BASE.  I've talked about these before with regard to EHR and HIE solutions.
HATEOAS is the RESTful model of interaction in a cloud based, BASE oriented world.

Which brings us to Pagination, the ability to look at the set of resources matching a particular query.

Pagination is a feature in a FHIR Server in which a query can specify a page size to indicate the maximum number of matches to return.

HAPI on FHIR has native support for pagination, but most implementation models come closer to an ACID model of the world.  Essential, the implementation memorizes the list of matching resource ids, and handle pagination from there, retrieving data as needed from the list associated with the query.  Thus, pages represent content at a given snapshot in time (which might be updated when results get stale or removed from any sort of cache).  In this model, you won't get unrepeatable reads or other issues wrt to transaction isolation, BUT, you could be looking at data that is not consistent with the current system state.

One of the points of pagination is to reduce server load.  Just getting the IDs and retrieving only what you need for a single page is a good start (and reduces network overhead), but it doesn't reduce the computational load to perform the actual query (and yes, I know, properly implemented, you can reduce it).

I use a more BASE oriented perspective, which is where results are retrieved a page at a time, and NEXT and PREV links are computed based on Resource.id.  Since the id values I use have the property that they are monotonically increasing from creation time, I can return resources in reverse order from creation time.  I could (and have) used last update time as the sort critiera as well.  Any sort key (including a composite key) that uniquely identifies a resources works in this model.

My NEXT and PREV links simply provide the sort key of the first and last resources in the current response in special parameters (I use _a and _b for after and before respectively).  To make things a little bit more complex, results are generally returned from most recent to least recent order (descending order), so I have to reverse my normal thought processes wrt order, but it works with either ascending or descending orders.

In the model I use, if something changes is the result set between one query and the next, you'll see the changes (which you won't always depending on how others implement the HAPI Pagination provider).  I could probably figure out how to handle this better and refactor my work to align it with the HAPI Pagination stuff, but what I've got is working.

Well, almost.  There is this issue that I've managed to workaround, so yeah it works, but I had to hack around a bug.

Tuesday, October 29, 2019

ML and AI in HealthIT ... things to think about

A very long time ago (at the beginning of my career in HealthIT), I got do do some really cool work on the front end and processing infrastructure for a set of machine learning and linguistic services that would automatically extract problems, medications, allergies and procedures and for problems, even code the diseases into a subset of SNOMED CT.  This was before most people had even heard about SNOMED CT, so some significant effort there.  We also did some work in the ICD-9-CM coding space as well, based on a software product that the company I worked for had purchased that was essentially the life's work of a physican / informaticist.

The product worked remarkably well from a technical perspective, and had a pretty decent precision/recall curve.  In fact, as configured, the system was shown to do as well as professional ICD-9-CM coders.

The biggest challenge it had was basically two-fold:

  1. It needed to be incorporate expert feedback to refine future results (we simply hadn't had the time to develop that feature).
  2. The original product couldn't explain how it got to a particular result, although subsequent ones could do a bit better.
To simplify, it couldn't argue for itself, or accept any corrections.

ML and AI are often "black boxes".  Most of what people are talking about with regard to AI today are implementations of some form of neural network.  Can anyone really explain what the weights and connections in a neural net mean?  This is a hard AI problem.  Machine learning algorithms have there own set of "hidden parameters" that drive their outputs, but that cannot always be easily explained.

Yet, we're expect to trust these things.  And they applied to hard problems that humans only solve correctly 90% of the time, and do slightly better.  How do you develop trust for something that's wrong for 1 out of 20 cases?  And yet we can trust a human because they can explain their reasoning, even when the result of it turned out wrong.

Interestingly enough, even when computers do as well as humans, the two together often do better than individually b/c the humans may understand nuance that the computer misses and vice versa.

If you are trying to implement AI (or ML), consider: 
  1. How do you work in user feedback about the goodness of the proposed solutions, 
  2. How will you explain to the user why this result is good.

Wednesday, October 23, 2019

Reporting on FHIR Structures

In yesterday's post, I mentioned that I had put together a report on FHIR resource use of code, Coding and CodeableConcept data types.  The stylesheet I used is provided below, and it was run over the profile-resources.xml file found in this download from the FHIR R4 website.

This is one of the truly valuable pieces of FHIR, that the specification itself is machine readable, which makes it possible to perform a variety of analyses and code generation tasks.

<?xml version="1.0" encoding="UTF-8"?>
<xsl:stylesheet xmlns:xsl="http://www.w3.org/1999/XSL/Transform"
    xmlns:xs="http://www.w3.org/2001/XMLSchema"
    xmlns:f="http://hl7.org/fhir"
    exclude-result-prefixes="xs"
    version="1.0">
    <xsl:output method="text"/>
    <xsl:template match="/">
        <xsl:text>Name,Type,Binding,Cardinality&#xA;</xsl:text>
        <xsl:apply-templates select="//f:snapshot/f:element"></xsl:apply-templates>
    </xsl:template>
    <xsl:template match="f:snapshot/f:element">
        <xsl:if test="f:binding">
            <xsl:value-of select="@id"/>
            <xsl:text>,</xsl:text>
            <xsl:apply-templates select="." mode='type'/>
            <xsl:text>,</xsl:text>
            <xsl:value-of select="f:binding/f:strength/@value"/>
            <xsl:text>,</xsl:text>
            <xsl:value-of select="f:min/@value"/>
            <xsl:text>..</xsl:text>
            <xsl:value-of select="f:max/@value"/>
            <xsl:text>&#xA;</xsl:text>
        </xsl:if>
    </xsl:template>
    <xsl:template match="f:element" mode='type'>
        <xsl:choose>
            <xsl:when test='f:type/f:code[@value = "code"]'>code</xsl:when>
            <xsl:when test='f:type/f:code[@value = "Coding"]'>Coding</xsl:when>
            <xsl:when test='f:type/f:code[@value = "CodeableConcept"]'>CodeableConcept</xsl:when>
            <xsl:when test='f:type/f:code[@value = "string"]'>string</xsl:when>
            <xsl:otherwise>
                <xsl:value-of select="f:type/f:code/@value"/>
            </xsl:otherwise>
        </xsl:choose>
    </xsl:template>
        
</xsl:stylesheet>

Tuesday, October 22, 2019

FHIR Terminology Datatype Usage Patterns

For the V2toFHIR project, I recently took up a task to write up my preferred approach for recording the original V2 code in FHIR Resources when mapping from a V2 message to FHIR.  To do that, I wanted to make a list of all the possible things that one might need to consider, so I ran a quick report of the variations in how code, Coding, and CodeableConcept are used with terminology in FHIR with respect to Binding Strength and Cardinality.

The report can be found at the bottom of the post.

Some interesting points:

code ~ required

The code datatype always uses a required vocabulary EXCEPT in one case in which it is preferred in Resource.language (which of course propagates to all resources in R4).  Now, why Resource.language says preferred instead of extensible is beyond me.  Who couldn't work with it as extensible?

max(cardinality(code)) is almost always 1

Instructive cases where there can be more than one code: AllergyIntolerance.category, Questionnaire.subjectType, CoverageEligibilityRequest.purpose and CoverageEligibilityResponse.purpose, anything dealing with daysOfWeek, and definition or conformance resources.  

The complete list where more than one can be used is AllergyIntolerance.category, CapabilityStatement.patchFormat, CapabilityStatement.rest.resource.referencePolicy, Endpoint.payloadMimeType, HealthcareService.availableTime.daysOfWeek, ImplementationGuide.definition.resource.fhirVersion
Location.hoursOfOperation.daysOfWeek, ObservationDefinition.permittedDataType, OperationDefinition.resource, PractitionerRole.availableTime.daysOfWeek, Questionnaire.subjectType, SearchParameter.comparator, SearchParameter.modifier, SearchParameter.target, StructureMap.group.rule.target.listMode, CapabilityStatement.format, 
CodeSystem.filter.operator, CoverageEligibilityRequest.purpose, CoverageEligibilityResponse.purpose, ImplementationGuide.fhirVersion, SearchParameter.base

Coding never uses required

The Coding data type is never bound with a required vocabulary, and rarely with a preferred one.  

Coding is not often used

In general, Coding is used 42 times, while CodableConcept is used 614 times. Hmm, do we really need Coding?  There are a few cases where I think the answer might be yes, but generally, I'd consider that most cases could probably survive quite well with just CodeableConcept.  In fact, in HL7 V2, CWE replaced ID/IS in the version 2.7 time frame throughout much of the specification.  There seem to be a small number of cases where Coding might be essential (QuestionnaireResponse.item.answer.value[x] could be one of these).

CodeableConcept has some interesting required cases

AdverseEvent.outcome, AdverseEvent.severity, AllergyIntolerance.clinicalStatus, AllergyIntolerance.verificationStatus, Condition.clinicalStatus, Condition.verificationStatus
These fields look mostly categorical and generally I have no complaints.  Seeing AdverseEvent.severity as a CodeableConcept makes me wonder though if AllergyIntolerance.criticality should also be CodeableConcept, or if the former should be code.

Measure.improvementNotation, MeasureReport.improvementNotation
The various improvementNotation attributes (on Measure and MeasureReport) could arguably be code.  I'm not sure what the use case is for CodableConcept in these.

EffectEvidenceSynthesis.effectEstimate.unitOfMeasure, 
ResearchElementDefinition.characteristic.unitOfMeasure, 
RiskEvidenceSynthesis.riskEstimate.unitOfMeasure
The unitOfMeasure fields above, when used alongside a decimal value argue that this information could have been modeled using SimpleQuantity to keep FHIR resources aligned around data types.

SupplyDelivery.type, InsurancePlan.plan.specificCost.benefit.cost.applicability, MolecularSequence.structureVariant.variantType
I don't have any feedback on these, just listing them for completeness.


Row Labels Count of Name
code 319
preferred 1
0..1 1
Resource.language 1
required 318
0..* 15
AllergyIntolerance.category 1
CapabilityStatement.patchFormat 1
CapabilityStatement.rest.resource.referencePolicy 1
Endpoint.payloadMimeType 1
HealthcareService.availableTime.daysOfWeek 1
ImplementationGuide.definition.resource.fhirVersion 1
Location.hoursOfOperation.daysOfWeek 1
ObservationDefinition.permittedDataType 1
OperationDefinition.resource 1
PractitionerRole.availableTime.daysOfWeek 1
Questionnaire.subjectType 1
SearchParameter.comparator 1
SearchParameter.modifier 1
SearchParameter.target 1
StructureMap.group.rule.target.listMode 1
0..1 112
ActivityDefinition.intent 1
ActivityDefinition.kind 1
ActivityDefinition.priority 1
AllergyIntolerance.criticality 1
AllergyIntolerance.reaction.severity 1
AllergyIntolerance.type 1
Appointment.participant.required 1
AuditEvent.action 1
AuditEvent.agent.network.type 1
AuditEvent.outcome 1
BiologicallyDerivedProduct.productCategory 1
BiologicallyDerivedProduct.status 1
BiologicallyDerivedProduct.storage.scale 1
Bundle.entry.search.mode 1
CapabilityStatement.rest.resource.conditionalDelete 1
CapabilityStatement.rest.resource.conditionalRead 1
CapabilityStatement.rest.resource.versioning 1
CarePlan.activity.detail.kind 1
CareTeam.status 1
CatalogEntry.status 1
ClaimResponse.processNote.type 1
CodeSystem.hierarchyMeaning 1
Communication.priority 1
CommunicationRequest.priority 1
Composition.confidentiality 1
Composition.section.mode 1
Consent.provision.type 1
Contract.status 1
DetectedIssue.severity 1
Device.status 1
Device.udiCarrier.entryType 1
DeviceMetric.calibration.state 1
DeviceMetric.calibration.type 1
DeviceMetric.color 1
DeviceMetric.operationalStatus 1
DeviceRequest.priority 1
DeviceRequest.status 1
DocumentReference.docStatus 1
EffectEvidenceSynthesis.resultsByExposure.exposureState 1
Encounter.location.status 1
EnrollmentRequest.status 1
EnrollmentResponse.outcome 1
EnrollmentResponse.status 1
EvidenceVariable.characteristic.groupMeasure 1
EvidenceVariable.type 1
ExplanationOfBenefit.processNote.type 1
ImplementationGuide.license 1
InsurancePlan.status 1
Location.mode 1
Location.status 1
Medication.status 1
MedicationKnowledge.status 1
MedicationRequest.priority 1
MessageDefinition.category 1
MessageDefinition.responseRequired 1
MolecularSequence.referenceSeq.orientation 1
MolecularSequence.referenceSeq.strand 1
MolecularSequence.type 1
ObservationDefinition.qualifiedInterval.category 1
ObservationDefinition.qualifiedInterval.gender 1
OperationDefinition.parameter.searchType 1
OperationDefinition.parameter.type 1
Patient.contact.gender 1
Patient.gender 1
PaymentReconciliation.outcome 1
PaymentReconciliation.processNote.type 1
Person.gender 1
Person.link.assurance 1
PlanDefinition.action.cardinalityBehavior 1
PlanDefinition.action.groupingBehavior 1
PlanDefinition.action.precheckBehavior 1
PlanDefinition.action.priority 1
PlanDefinition.action.requiredBehavior 1
PlanDefinition.action.selectionBehavior 1
Practitioner.gender 1
Questionnaire.item.enableBehavior 1
RelatedPerson.gender 1
RequestGroup.action.cardinalityBehavior 1
RequestGroup.action.groupingBehavior 1
RequestGroup.action.precheckBehavior 1
RequestGroup.action.priority 1
RequestGroup.action.requiredBehavior 1
RequestGroup.action.selectionBehavior 1
RequestGroup.priority 1
ResearchElementDefinition.characteristic.participantEffectiveGroupMeasure 1
ResearchElementDefinition.characteristic.studyEffectiveGroupMeasure 1
ResearchElementDefinition.variableType 1
SearchParameter.xpathUsage 1
ServiceRequest.priority 1
Specimen.status 1
StructureDefinition.derivation 1
StructureDefinition.fhirVersion 1
StructureMap.group.rule.source.listMode 1
StructureMap.group.rule.target.contextType 1
StructureMap.group.rule.target.transform 1
Subscription.channel.payload 1
Substance.status 1
SupplyDelivery.status 1
SupplyRequest.priority 1
SupplyRequest.status 1
Task.priority 1
TerminologyCapabilities.codeSearch 1
TestScript.setup.action.assert.contentType 1
TestScript.setup.action.assert.direction 1
TestScript.setup.action.assert.operator 1
TestScript.setup.action.assert.requestMethod 1
TestScript.setup.action.assert.resource 1
TestScript.setup.action.assert.response 1
TestScript.setup.action.operation.accept 1
TestScript.setup.action.operation.contentType 1
TestScript.setup.action.operation.method 1
TestScript.setup.action.operation.resource 1
1..* 6
CapabilityStatement.format 1
CodeSystem.filter.operator 1
CoverageEligibilityRequest.purpose 1
CoverageEligibilityResponse.purpose 1
ImplementationGuide.fhirVersion 1
SearchParameter.base 1
1..1 185
Account.status 1
ActivityDefinition.participant.type 1
ActivityDefinition.status 1
AdverseEvent.actuality 1
Appointment.participant.status 1
Appointment.status 1
AppointmentResponse.participantStatus 1
Binary.contentType 1
Bundle.entry.request.method 1
Bundle.type 1
CapabilityStatement.document.mode 1
CapabilityStatement.fhirVersion 1
CapabilityStatement.kind 1
CapabilityStatement.messaging.supportedMessage.mode 1
CapabilityStatement.rest.interaction.code 1
CapabilityStatement.rest.mode 1
CapabilityStatement.rest.resource.interaction.code 1
CapabilityStatement.rest.resource.searchParam.type 1
CapabilityStatement.rest.resource.type 1
CapabilityStatement.status 1
CarePlan.activity.detail.status 1
CarePlan.intent 1
CarePlan.status 1
CatalogEntry.relatedEntry.relationtype 1
ChargeItem.status 1
ChargeItemDefinition.propertyGroup.priceComponent.type 1
ChargeItemDefinition.status 1
Claim.status 1
Claim.use 1
ClaimResponse.outcome 1
ClaimResponse.status 1
ClaimResponse.use 1
ClinicalImpression.status 1
CodeSystem.content 1
CodeSystem.property.type 1
CodeSystem.status 1
Communication.status 1
CommunicationRequest.status 1
CompartmentDefinition.code 1
CompartmentDefinition.resource.code 1
CompartmentDefinition.status 1
Composition.attester.mode 1
Composition.relatesTo.code 1
Composition.status 1
ConceptMap.group.element.target.equivalence 1
ConceptMap.group.unmapped.mode 1
ConceptMap.status 1
Consent.provision.data.meaning 1
Consent.status 1
Contract.contentDefinition.publicationStatus 1
Coverage.status 1
CoverageEligibilityRequest.status 1
CoverageEligibilityResponse.outcome 1
CoverageEligibilityResponse.status 1
DetectedIssue.status 1
Device.deviceName.type 1
DeviceDefinition.deviceName.type 1
DeviceMetric.category 1
DeviceRequest.intent 1
DeviceUseStatement.status 1
DiagnosticReport.status 1
DocumentManifest.status 1
DocumentReference.relatesTo.code 1
DocumentReference.status 1
EffectEvidenceSynthesis.status 1
Encounter.status 1
Encounter.statusHistory.status 1
Endpoint.status 1
EpisodeOfCare.status 1
EpisodeOfCare.statusHistory.status 1
EventDefinition.status 1
Evidence.status 1
EvidenceVariable.status 1
ExampleScenario.actor.type 1
ExampleScenario.instance.resourceType 1
ExampleScenario.status 1
ExplanationOfBenefit.outcome 1
ExplanationOfBenefit.status 1
ExplanationOfBenefit.use 1
FamilyMemberHistory.status 1
Flag.status 1
Goal.lifecycleStatus 1
GraphDefinition.link.target.compartment.code 1
GraphDefinition.link.target.compartment.rule 1
GraphDefinition.link.target.compartment.use 1
GraphDefinition.link.target.type 1
GraphDefinition.start 1
GraphDefinition.status 1
Group.type 1
GuidanceResponse.status 1
ImagingStudy.status 1
Immunization.status 1
ImmunizationEvaluation.status 1
ImplementationGuide.definition.page.generation 1
ImplementationGuide.definition.parameter.code 1
ImplementationGuide.global.type 1
ImplementationGuide.status 1
Invoice.lineItem.priceComponent.type 1
Invoice.status 1
Library.status 1
Linkage.item.type 1
List.mode 1
List.status 1
Measure.status 1
MeasureReport.status 1
MeasureReport.type 1
Media.status 1
MedicationAdministration.status 1
MedicationDispense.status 1
MedicationRequest.intent 1
MedicationRequest.status 1
MedicationStatement.status 1
MessageDefinition.focus.code 1
MessageDefinition.status 1
MessageHeader.response.code 1
MetadataResource.status 1
MolecularSequence.quality.type 1
MolecularSequence.repository.type 1
NamingSystem.kind 1
NamingSystem.status 1
NamingSystem.uniqueId.type 1
NutritionOrder.intent 1
NutritionOrder.status 1
Observation.status 1
OperationDefinition.kind 1
OperationDefinition.parameter.binding.strength 1
OperationDefinition.parameter.use 1
OperationDefinition.status 1
OperationOutcome.issue.code 1
OperationOutcome.issue.severity 1
Patient.link.type 1
PaymentNotice.status 1
PaymentReconciliation.status 1
PlanDefinition.action.condition.kind 1
PlanDefinition.action.participant.type 1
PlanDefinition.action.relatedAction.relationship 1
PlanDefinition.status 1
Procedure.status 1
Provenance.entity.role 1
Questionnaire.item.enableWhen.operator 1
Questionnaire.item.type 1
Questionnaire.status 1
QuestionnaireResponse.status 1
RequestGroup.action.condition.kind 1
RequestGroup.action.relatedAction.relationship 1
RequestGroup.intent 1
RequestGroup.status 1
ResearchDefinition.status 1
ResearchElementDefinition.status 1
ResearchElementDefinition.type 1
ResearchStudy.status 1
ResearchSubject.status 1
RiskAssessment.status 1
RiskEvidenceSynthesis.status 1
SearchParameter.status 1
SearchParameter.type 1
ServiceRequest.intent 1
ServiceRequest.status 1
Slot.status 1
SpecimenDefinition.typeTested.preference 1
StructureDefinition.context.type 1
StructureDefinition.kind 1
StructureDefinition.status 1
StructureMap.group.input.mode 1
StructureMap.group.typeMode 1
StructureMap.status 1
StructureMap.structure.mode 1
Subscription.channel.type 1
Subscription.status 1
Task.intent 1
Task.status 1
TerminologyCapabilities.kind 1
TerminologyCapabilities.status 1
TestReport.participant.type 1
TestReport.result 1
TestReport.setup.action.assert.result 1
TestReport.setup.action.operation.result 1
TestReport.status 1
TestScript.status 1
ValueSet.compose.include.filter.op 1
ValueSet.status 1
VerificationResult.status 1
VisionPrescription.lensSpecification.eye 1
VisionPrescription.lensSpecification.prism.base 1
VisionPrescription.status 1
CodeableConcept 614
example 432
0..* 152
ActivityDefinition.bodySite 1
ActivityDefinition.topic 1
Appointment.serviceCategory 1
Appointment.serviceType 1
AuditEvent.agent.role 1
BodyStructure.locationQualifier 1
CarePlan.activity.detail.reasonCode 1
CarePlan.activity.outcomeCodeableConcept 1
CarePlan.category 1
CareTeam.category 1
CareTeam.participant.role 1
CareTeam.reasonCode 1
ChargeItem.bodysite 1
ChargeItem.reason 1
Claim.diagnosis.type 1
Claim.item.detail.modifier 1
Claim.item.detail.programCode 1
Claim.item.detail.subDetail.modifier 1
Claim.item.detail.subDetail.programCode 1
Claim.item.modifier 1
Claim.item.programCode 1
Claim.item.subSite 1
Claim.procedure.type 1
ClaimResponse.addItem.detail.modifier 1
ClaimResponse.addItem.detail.subDetail.modifier 1
ClaimResponse.addItem.modifier 1
ClaimResponse.addItem.programCode 1
ClaimResponse.addItem.subSite 1
ClinicalImpression.prognosisCodeableConcept 1
Communication.category 1
Communication.medium 1
Communication.reasonCode 1
CommunicationRequest.category 1
CommunicationRequest.medium 1
CommunicationRequest.reasonCode 1
Composition.category 1
Composition.event.code 1
Condition.bodySite 1
Condition.evidence.code 1
Consent.provision.action 1
Consent.provision.code 1
Contract.subType 1
Contract.term.action.performerType 1
Contract.term.action.reasonCode 1
Contract.term.asset.context.code 1
Contract.term.asset.periodType 1
Contract.term.asset.subtype 1
Contract.term.asset.type 1
Contract.term.offer.decisionMode 1
CoverageEligibilityRequest.item.modifier 1
CoverageEligibilityResponse.insurance.item.authorizationSupporting 1
CoverageEligibilityResponse.insurance.item.modifier 1
DetectedIssue.evidence.code 1
DeviceDefinition.safety 1
DeviceRequest.reasonCode 1
DiagnosticReport.category 1
DiagnosticReport.conclusionCode 1
DocumentReference.category 1
DocumentReference.context.event 1
EffectEvidenceSynthesis.topic 1
Encounter.hospitalization.dietPreference 1
Encounter.type 1
EpisodeOfCare.type 1
EventDefinition.topic 1
Evidence.topic 1
EvidenceVariable.topic 1
ExplanationOfBenefit.addItem.detail.modifier 1
ExplanationOfBenefit.addItem.detail.subDetail.modifier 1
ExplanationOfBenefit.addItem.modifier 1
ExplanationOfBenefit.addItem.programCode 1
ExplanationOfBenefit.addItem.subSite 1
ExplanationOfBenefit.diagnosis.type 1
ExplanationOfBenefit.item.detail.modifier 1
ExplanationOfBenefit.item.detail.programCode 1
ExplanationOfBenefit.item.detail.subDetail.modifier 1
ExplanationOfBenefit.item.detail.subDetail.programCode 1
ExplanationOfBenefit.item.modifier 1
ExplanationOfBenefit.item.programCode 1
ExplanationOfBenefit.item.subSite 1
ExplanationOfBenefit.procedure.type 1
FamilyMemberHistory.reasonCode 1
Flag.category 1
Goal.category 1
Goal.outcomeCode 1
HealthcareService.category 1
HealthcareService.characteristic 1
HealthcareService.program 1
HealthcareService.referralMethod 1
HealthcareService.serviceProvisionCode 1
HealthcareService.type 1
ImagingStudy.reasonCode 1
Immunization.programEligibility 1
Immunization.protocolApplied.targetDisease 1
Immunization.reasonCode 1
Immunization.subpotentReason 1
ImmunizationEvaluation.doseStatusReason 1
ImmunizationRecommendation.recommendation.contraindicatedVaccineCode 1
ImmunizationRecommendation.recommendation.forecastReason 1
ImmunizationRecommendation.recommendation.vaccineCode 1
InsurancePlan.type 1
Library.topic 1
Measure.topic 1
Media.reasonCode 1
MedicationAdministration.reasonCode 1
MedicationAdministration.statusReason 1
MedicationDispense.substitution.reason 1
MedicationKnowledge.intendedRoute 1
MedicationRequest.category 1
MedicationRequest.reasonCode 1
MedicationStatement.reasonCode 1
MedicationStatement.statusReason 1
NutritionOrder.excludeFoodModifier 1
NutritionOrder.foodPreferenceModifier 1
NutritionOrder.oralDiet.fluidConsistencyType 1
NutritionOrder.oralDiet.type 1
Observation.referenceRange.appliesTo 1
ObservationDefinition.category 1
ObservationDefinition.qualifiedInterval.appliesTo 1
Organization.type 1
OrganizationAffiliation.code 1
PlanDefinition.goal.addresses 1
PlanDefinition.topic 1
PractitionerRole.code 1
Procedure.bodySite 1
Procedure.complication 1
Procedure.followUp 1
Procedure.reasonCode 1
Procedure.usedCode 1
Provenance.agent.role 1
ResearchDefinition.topic 1
ResearchElementDefinition.topic 1
ResearchStudy.category 1
ResearchStudy.condition 1
ResearchStudy.focus 1
ResearchStudy.keyword 1
RiskEvidenceSynthesis.topic 1
Schedule.serviceCategory 1
Schedule.serviceType 1
ServiceRequest.bodySite 1
ServiceRequest.category 1
ServiceRequest.locationCode 1
ServiceRequest.orderDetail 1
ServiceRequest.reasonCode 1
Slot.serviceCategory 1
Slot.serviceType 1
SpecimenDefinition.collection 1
SpecimenDefinition.patientPreparation 1
SpecimenDefinition.typeTested.rejectionCriterion 1
SupplyRequest.reasonCode 1
VerificationResult.primarySource.communicationMethod 1
VerificationResult.primarySource.type 1
VerificationResult.validationProcess 1
0..1 209
Account.type 1
ActivityDefinition.code 1
ActivityDefinition.participant.role 1
ActivityDefinition.product[x] 1
AdverseEvent.event 1
AdverseEvent.seriousness 1
AdverseEvent.suspectEntity.causality.assessment 1
AdverseEvent.suspectEntity.causality.method 1
AllergyIntolerance.code 1
AllergyIntolerance.reaction.exposureRoute 1
AllergyIntolerance.reaction.substance 1
Appointment.cancelationReason 1
BiologicallyDerivedProduct.processing.procedure 1
BiologicallyDerivedProduct.productCode 1
BodyStructure.location 1
BodyStructure.morphology 1
CarePlan.activity.detail.code 1
CarePlan.activity.detail.product[x] 1
ChargeItem.performer.function 1
ChargeItem.product[x] 1
ChargeItemDefinition.code 1
Claim.careTeam.qualification 1
Claim.careTeam.role 1
Claim.diagnosis.onAdmission 1
Claim.diagnosis.packageCode 1
Claim.fundsReserve 1
Claim.item.bodySite 1
Claim.item.category 1
Claim.item.detail.category 1
Claim.item.detail.revenue 1
Claim.item.detail.subDetail.category 1
Claim.item.detail.subDetail.revenue 1
Claim.item.location[x] 1
Claim.item.revenue 1
Claim.related.relationship 1
Claim.subType 1
Claim.supportingInfo.code 1
Claim.supportingInfo.reason 1
ClaimResponse.addItem.bodySite 1
ClaimResponse.addItem.location[x] 1
ClaimResponse.formCode 1
ClaimResponse.fundsReserve 1
ClaimResponse.item.adjudication.reason 1
ClaimResponse.payeeType 1
ClaimResponse.payment.adjustmentReason 1
ClaimResponse.subType 1
ClinicalImpression.code 1
ClinicalImpression.finding.itemCodeableConcept 1
ClinicalImpression.statusReason 1
Communication.statusReason 1
Communication.topic 1
CommunicationRequest.statusReason 1
Composition.section.code 1
Condition.code 1
Condition.stage.summary 1
Condition.stage.type 1
Contract.contentDefinition.subType 1
Contract.contentDerivative 1
Contract.expirationType 1
Contract.scope 1
Contract.term.action.performerRole 1
Contract.term.action.subject.role 1
Contract.term.asset.scope 1
Contract.term.offer.type 1
Contract.term.subType 1
Contract.term.type 1
Contract.type 1
CoverageEligibilityRequest.item.category 1
CoverageEligibilityRequest.item.diagnosis.diagnosis[x] 1
CoverageEligibilityRequest.item.productOrService 1
CoverageEligibilityRequest.priority 1
CoverageEligibilityResponse.form 1
CoverageEligibilityResponse.insurance.item.category 1
CoverageEligibilityResponse.insurance.item.network 1
CoverageEligibilityResponse.insurance.item.productOrService 1
CoverageEligibilityResponse.insurance.item.term 1
CoverageEligibilityResponse.insurance.item.unit 1
Device.type 1
DeviceDefinition.type 1
DeviceRequest.parameter.code 1
DeviceRequest.performerType 1
DeviceUseStatement.bodySite 1
DocumentManifest.type 1
DocumentReference.context.facilityType 1
DocumentReference.context.practiceSetting 1
Encounter.hospitalization.dischargeDisposition 1
Encounter.hospitalization.reAdmission 1
Encounter.location.physicalType 1
Encounter.priority 1
Encounter.serviceType 1
ExplanationOfBenefit.addItem.bodySite 1
ExplanationOfBenefit.addItem.location[x] 1
ExplanationOfBenefit.benefitBalance.network 1
ExplanationOfBenefit.benefitBalance.term 1
ExplanationOfBenefit.benefitBalance.unit 1
ExplanationOfBenefit.careTeam.qualification 1
ExplanationOfBenefit.careTeam.role 1
ExplanationOfBenefit.diagnosis.onAdmission 1
ExplanationOfBenefit.diagnosis.packageCode 1
ExplanationOfBenefit.formCode 1
ExplanationOfBenefit.fundsReserve 1
ExplanationOfBenefit.fundsReserveRequested 1
ExplanationOfBenefit.item.adjudication.reason 1
ExplanationOfBenefit.item.bodySite 1
ExplanationOfBenefit.item.category 1
ExplanationOfBenefit.item.detail.category 1
ExplanationOfBenefit.item.detail.revenue 1
ExplanationOfBenefit.item.detail.subDetail.category 1
ExplanationOfBenefit.item.detail.subDetail.revenue 1
ExplanationOfBenefit.item.location[x] 1
ExplanationOfBenefit.item.revenue 1
ExplanationOfBenefit.payee.type 1
ExplanationOfBenefit.payment.adjustmentReason 1
ExplanationOfBenefit.payment.type 1
ExplanationOfBenefit.priority 1
ExplanationOfBenefit.related.relationship 1
ExplanationOfBenefit.subType 1
ExplanationOfBenefit.supportingInfo.code 1
FamilyMemberHistory.condition.outcome 1
FamilyMemberHistory.dataAbsentReason 1
Goal.start[x] 1
Goal.target.detail[x] 1
Goal.target.measure 1
Group.code 1
HealthcareService.eligibility.code 1
Immunization.fundingSource 1
Immunization.reportOrigin 1
Immunization.route 1
Immunization.site 1
Immunization.statusReason 1
ImmunizationRecommendation.recommendation.targetDisease 1
List.code 1
List.entry.flag 1
Location.physicalType 1
Media.bodySite 1
Media.modality 1
Media.view 1
Medication.code 1
Medication.form 1
MedicationAdministration.dosage.method 1
MedicationAdministration.dosage.route 1
MedicationAdministration.dosage.site 1
MedicationAdministration.performer.function 1
MedicationDispense.performer.function 1
MedicationDispense.statusReason[x] 1
MedicationDispense.substitution.type 1
MedicationDispense.type 1
MedicationKnowledge.code 1
MedicationKnowledge.doseForm 1
MedicationKnowledge.drugCharacteristic.type 1
MedicationKnowledge.packaging.type 1
MedicationRequest.courseOfTherapyType 1
MedicationRequest.performerType 1
MedicationRequest.statusReason 1
MedicationRequest.substitution.reason 1
MessageHeader.reason 1
MolecularSequence.quality.method 1
MolecularSequence.quality.standardSequence 1
MolecularSequence.referenceSeq.chromosome 1
MolecularSequence.referenceSeq.referenceSeqId 1
NutritionOrder.enteralFormula.additiveType 1
NutritionOrder.enteralFormula.baseFormulaType 1
NutritionOrder.oralDiet.nutrient.modifier 1
NutritionOrder.oralDiet.texture.foodType 1
NutritionOrder.oralDiet.texture.modifier 1
NutritionOrder.supplement.type 1
Observation.bodySite 1
Observation.method 1
ObservationDefinition.method 1
OperationOutcome.issue.details 1
PaymentNotice.paymentStatus 1
PaymentReconciliation.formCode 1
PlanDefinition.action.participant.role 1
PlanDefinition.goal.category 1
PlanDefinition.goal.start 1
PlanDefinition.goal.target.measure 1
Procedure.category 1
Procedure.code 1
Procedure.outcome 1
Procedure.performer.function 1
Procedure.statusReason 1
ResearchStudy.phase 1
ResearchStudy.reasonStopped 1
RiskAssessment.method 1
RiskAssessment.prediction.outcome 1
RiskAssessment.prediction.qualitativeRisk 1
ServiceRequest.asNeeded[x] 1
ServiceRequest.code 1
ServiceRequest.performerType 1
Specimen.collection.bodySite 1
Specimen.collection.method 1
Specimen.container.additive[x] 1
Specimen.container.type 1
Specimen.processing.procedure 1
Specimen.type 1
SpecimenDefinition.typeCollected 1
SpecimenDefinition.typeTested.container.cap 1
SpecimenDefinition.typeTested.container.material 1
SpecimenDefinition.typeTested.container.type 1
SpecimenDefinition.typeTested.handling.temperatureQualifier 1
SpecimenDefinition.typeTested.type 1
SupplyDelivery.suppliedItem.item[x] 1
SupplyRequest.category 1
SupplyRequest.parameter.code 1
Task.businessStatus 1
Task.code 1
Task.reasonCode 1
Task.statusReason 1
VerificationResult.attestation.communicationMethod 1
1..* 2
AllergyIntolerance.reaction.manifestation 1
Endpoint.payloadType 1
1..1 69
Basic.code 1
ChargeItem.code 1
Claim.diagnosis.diagnosis[x] 1
Claim.item.detail.productOrService 1
Claim.item.detail.subDetail.productOrService 1
Claim.item.productOrService 1
Claim.payee.type 1
Claim.priority 1
Claim.procedure.procedure[x] 1
Claim.supportingInfo.category 1
ClaimResponse.addItem.detail.productOrService 1
ClaimResponse.addItem.detail.subDetail.productOrService 1
ClaimResponse.addItem.productOrService 1
ClaimResponse.error.code 1
ClaimResponse.item.adjudication.category 1
ClaimResponse.payment.type 1
ClaimResponse.total.category 1
ClinicalImpression.investigation.code 1
Contract.contentDefinition.type 1
Contract.term.action.intent 1
Contract.term.action.status 1
Contract.term.action.type 1
Contract.term.offer.party.role 1
Coverage.costToBeneficiary.exception.type 1
CoverageEligibilityResponse.error.code 1
CoverageEligibilityResponse.insurance.item.benefit.type 1
DeviceRequest.code[x] 1
ExplanationOfBenefit.addItem.detail.productOrService 1
ExplanationOfBenefit.addItem.detail.subDetail.productOrService 1
ExplanationOfBenefit.addItem.productOrService 1
ExplanationOfBenefit.benefitBalance.category 1
ExplanationOfBenefit.benefitBalance.financial.type 1
ExplanationOfBenefit.diagnosis.diagnosis[x] 1
ExplanationOfBenefit.item.adjudication.category 1
ExplanationOfBenefit.item.detail.productOrService 1
ExplanationOfBenefit.item.detail.subDetail.productOrService 1
ExplanationOfBenefit.item.productOrService 1
ExplanationOfBenefit.procedure.procedure[x] 1
ExplanationOfBenefit.supportingInfo.category 1
ExplanationOfBenefit.total.category 1
FamilyMemberHistory.condition.code 1
FamilyMemberHistory.relationship 1
Flag.code 1
Goal.description 1
Group.characteristic.code 1
Group.characteristic.value[x] 1
Immunization.vaccineCode 1
ImmunizationEvaluation.doseStatus 1
ImmunizationEvaluation.targetDisease 1
ImmunizationRecommendation.recommendation.dateCriterion.code 1
ImmunizationRecommendation.recommendation.forecastStatus 1
MedicationAdministration.medication[x] 1
MedicationDispense.medication[x] 1
MedicationRequest.medication[x] 1
MedicationRequest.substitution.allowed[x] 1
MedicationStatement.medication[x] 1
Observation.code 1
Observation.component.code 1
ObservationDefinition.code 1
PaymentReconciliation.detail.type 1
PlanDefinition.goal.description 1
Practitioner.qualification.code 1
SpecimenDefinition.typeTested.container.additive.additive[x] 1
Substance.code 1
Substance.ingredient.substance[x] 1
SupplyRequest.item[x] 1
Task.input.type 1
Task.output.type 1
VisionPrescription.lensSpecification.product 1
extensible 116
0..* 54
ActivityDefinition.jurisdiction 1
AdverseEvent.category 1
Appointment.participant.type 1
AppointmentResponse.participantType 1
AuditEvent.agent.purposeOfUse 1
AuditEvent.purposeOfEvent 1
CapabilityStatement.jurisdiction 1
CapabilityStatement.rest.security.service 1
ChargeItemDefinition.jurisdiction 1
CodeSystem.jurisdiction 1
ConceptMap.jurisdiction 1
Condition.category 1
Device.statusReason 1
DocumentReference.securityLabel 1
EffectEvidenceSynthesis.certainty.certaintySubcomponent.rating 1
EffectEvidenceSynthesis.certainty.rating 1
EffectEvidenceSynthesis.jurisdiction 1
Encounter.participant.type 1
EventDefinition.jurisdiction 1
Evidence.jurisdiction 1
EvidenceVariable.jurisdiction 1
ExampleScenario.jurisdiction 1
GraphDefinition.jurisdiction 1
ImagingStudy.procedureCode 1
ImplementationGuide.jurisdiction 1
Library.jurisdiction 1
Location.type 1
Measure.jurisdiction 1
Measure.supplementalData.usage 1
Measure.type 1
MessageDefinition.jurisdiction 1
MetadataResource.jurisdiction 1
NamingSystem.jurisdiction 1
Observation.component.interpretation 1
Observation.interpretation 1
OperationDefinition.jurisdiction 1
Patient.contact.relationship 1
PlanDefinition.jurisdiction 1
Provenance.reason 1
Questionnaire.jurisdiction 1
ResearchDefinition.jurisdiction 1
ResearchElementDefinition.jurisdiction 1
ResearchStudy.location 1
RiskEvidenceSynthesis.certainty.certaintySubcomponent.rating 1
RiskEvidenceSynthesis.certainty.rating 1
RiskEvidenceSynthesis.jurisdiction 1
SearchParameter.jurisdiction 1
Specimen.condition 1
StructureDefinition.jurisdiction 1
StructureMap.jurisdiction 1
Substance.category 1
TerminologyCapabilities.jurisdiction 1
TestScript.jurisdiction 1
ValueSet.jurisdiction 1
0..1 54
ActivityDefinition.subject[x] 1
AuditEvent.agent.type 1
Claim.accident.type 1
Consent.policyRule 1
Contract.legalState 1
Contract.term.offer.decision 1
Coverage.costToBeneficiary.type 1
Coverage.relationship 1
EffectEvidenceSynthesis.certainty.certaintySubcomponent.type 1
EffectEvidenceSynthesis.effectEstimate.precisionEstimate.type 1
EffectEvidenceSynthesis.effectEstimate.type 1
EffectEvidenceSynthesis.effectEstimate.variantState 1
EffectEvidenceSynthesis.resultsByExposure.variantState 1
EffectEvidenceSynthesis.studyType 1
EffectEvidenceSynthesis.synthesisType 1
EventDefinition.subject[x] 1
ExplanationOfBenefit.accident.type 1
FamilyMemberHistory.sex 1
ImagingStudy.series.performer.function 1
Immunization.performer.function 1
InsurancePlan.contact.purpose 1
Library.subject[x] 1
Measure.compositeScoring 1
Measure.group.population.code 1
Measure.scoring 1
Measure.subject[x] 1
MeasureReport.group.population.code 1
MeasureReport.group.stratifier.stratum.population.code 1
Media.type 1
NamingSystem.type 1
NutritionOrder.enteralFormula.routeofAdministration 1
Observation.component.dataAbsentReason 1
Observation.dataAbsentReason 1
ObservationDefinition.qualifiedInterval.context 1
ObservationDefinition.quantitativeDetails.customaryUnit 1
ObservationDefinition.quantitativeDetails.unit 1
Organization.contact.purpose 1
Patient.maritalStatus 1
PlanDefinition.action.subject[x] 1
PlanDefinition.action.type 1
PlanDefinition.subject[x] 1
PlanDefinition.type 1
Provenance.activity 1
Provenance.agent.type 1
RequestGroup.action.type 1
ResearchDefinition.subject[x] 1
ResearchElementDefinition.subject[x] 1
ResearchStudy.primaryPurposeType 1
RiskEvidenceSynthesis.certainty.certaintySubcomponent.type 1
RiskEvidenceSynthesis.riskEstimate.precisionEstimate.type 1
RiskEvidenceSynthesis.riskEstimate.type 1
RiskEvidenceSynthesis.studyType 1
RiskEvidenceSynthesis.synthesisType 1
Specimen.collection.fastingStatus[x] 1
1..* 1
Consent.category 1
1..1 7
Claim.type 1
ClaimResponse.type 1
Consent.provision.actor.role 1
Consent.scope 1
Coverage.class.type 1
ExplanationOfBenefit.type 1
Library.type 1
preferred 52
0..* 16
Appointment.reasonCode 1
Appointment.specialty 1
Encounter.hospitalization.specialArrangement 1
Encounter.hospitalization.specialCourtesy 1
Encounter.reasonCode 1
HealthcareService.communication 1
HealthcareService.specialty 1
Observation.category 1
OrganizationAffiliation.specialty 1
Practitioner.communication 1
PractitionerRole.specialty 1
RelatedPerson.relationship 1
Schedule.specialty 1
Slot.specialty 1
Task.performerType 1
VerificationResult.primarySource.pushTypeAvailable 1
0..1 30
Appointment.appointmentType 1
ClaimResponse.processNote.language 1
Composition.section.emptyReason 1
Composition.section.orderedBy 1
Condition.severity 1
Coverage.type 1
DetectedIssue.code 1
DeviceMetric.unit 1
DocumentReference.type 1
Encounter.diagnosis.use 1
Encounter.hospitalization.admitSource 1
EpisodeOfCare.diagnosis.role 1
ExplanationOfBenefit.processNote.language 1
Goal.achievementStatus 1
Goal.priority 1
List.emptyReason 1
List.orderedBy 1
MedicationAdministration.category 1
MedicationDispense.category 1
MedicationStatement.category 1
Observation.referenceRange.type 1
PlanDefinition.goal.priority 1
Procedure.focalDevice.action 1
ResearchStudy.objective.type 1
Slot.appointmentType 1
VerificationResult.failureAction 1
VerificationResult.need 1
VerificationResult.primarySource.canPushUpdates 1
VerificationResult.primarySource.validationStatus 1
VerificationResult.validationType 1
1..1 6
Composition.type 1
DetectedIssue.mitigation.action 1
DeviceMetric.type 1
DiagnosticReport.code 1
Patient.communication.language 1
RelatedPerson.communication.language 1
required 14
0..1 14
AdverseEvent.outcome 1
AdverseEvent.severity 1
AllergyIntolerance.clinicalStatus 1
AllergyIntolerance.verificationStatus 1
Condition.clinicalStatus 1
Condition.verificationStatus 1
EffectEvidenceSynthesis.effectEstimate.unitOfMeasure 1
InsurancePlan.plan.specificCost.benefit.cost.applicability 1
Measure.improvementNotation 1
MeasureReport.improvementNotation 1
MolecularSequence.structureVariant.variantType 1
ResearchElementDefinition.characteristic.unitOfMeasure 1
RiskEvidenceSynthesis.riskEstimate.unitOfMeasure 1
SupplyDelivery.type 1
Coding 42
example 14
0..* 4
Contract.term.securityLabel.category 1
Contract.term.securityLabel.control 1
Questionnaire.code 1
Questionnaire.item.code 1
0..1 4
ExplanationOfBenefit.supportingInfo.reason 1
ImagingStudy.series.bodySite 1
ImagingStudy.series.laterality 1
QuestionnaireResponse.item.answer.value[x] 1
1..1 6
Contract.term.securityLabel.classification 1
MessageDefinition.event[x] 1
MessageHeader.event[x] 1
Questionnaire.item.answerOption.value[x] 1
Questionnaire.item.enableWhen.answer[x] 1
Questionnaire.item.initial.value[x] 1
extensible 25
0..* 8
AuditEvent.entity.securityLabel 1
AuditEvent.source.type 1
AuditEvent.subtype 1
Consent.provision.class 1
Consent.provision.purpose 1
Consent.provision.securityLabel 1
ImagingStudy.modality 1
StructureDefinition.keyword 1
0..1 8
AuditEvent.agent.media 1
AuditEvent.entity.lifecycle 1
AuditEvent.entity.role 1
AuditEvent.entity.type 1
CodeSystem.concept.designation.use 1
Contract.term.asset.relationship 1
TestScript.setup.action.operation.type 1
ValueSet.compose.include.concept.designation.use 1
1..1 9
AuditEvent.type 1
CapabilityStatement.messaging.endpoint.protocol 1
Encounter.class 1
Encounter.classHistory.class 1
Endpoint.connectionType 1
ImagingStudy.series.instance.sopClass 1
ImagingStudy.series.modality 1
TestScript.destination.profile 1
TestScript.origin.profile 1
preferred 3
0..1 2
DocumentReference.content.format 1
Location.operationalStatus 1
1..1 1
Contract.signer.type 1
Grand Total 975