Nictiz FHIR NL STU3 Zib2017
1.3.15 - CI Build

Nictiz FHIR NL STU3 Zib2017 - Local Development build (v1.3.15) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Zib HearingFunction HearingAid - Detailed Descriptions

Draft as of 2024-04-09

Definitions for the zib-HearingFunction-HearingAid resource profile.

Guidance on how to interpret the contents of this table can be found here

0. DeviceUseStatement
Definition

The medical aid used to help the patient hear.

ShortHearingAid
Alternate NamesHorenHulpmiddel
2. DeviceUseStatement.extension
SlicingThis element introduces a set of slices on DeviceUseStatement.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. DeviceUseStatement.extension:reasonReference
    Slice NamereasonReference
    6. DeviceUseStatement.extension:reasonReference.url
    Fixed ValuereasonReference
    8. DeviceUseStatement.extension:reasonReference.valueReference:valueReference
    Slice NamevalueReference
    TypeReference(HCIM HearingFunction)
    10. DeviceUseStatement.device
    TypeReference(http://nictiz.nl/fhir/StructureDefinition/zib-HearingAid-Product)
    12. DeviceUseStatement.bodySite
    Definition

    The anatomical location of the hearing aid, such as: ‘left ear’.

    ShortDeviceAnatomicalLocation
    BindingUnless not suitable, these codes SHALL be taken from LocatieGehoorapparaatCodelijst
    (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.17.3--20171231000000)
    Alternate NamesHulpmiddelAnatomischeLocatie

    Guidance on how to interpret the contents of this table can be found here

    0. DeviceUseStatement
    Definition

    The medical aid used to help the patient hear.


    A record of a device being used by a patient where the record is the result of a report from the patient or another clinician.

    ShortHearingAidRecord of use of a device
    Control0..*
    Alternate NamesMedischHulpmiddel, HorenHulpmiddel
    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
    dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
    dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
    dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
    dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
    dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
    2. DeviceUseStatement.implicitRules
    Definition

    A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

    ShortA set of rules under which this content was created
    Comments

    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.

    Control0..1
    Typeuri
    Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    4. DeviceUseStatement.extension
    Definition

    An Extension


    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.

    ShortExtensionAdditional Content defined by implementations
    Comments

    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.

    Control0..*
    TypeExtension
    Alternate Namesextensions, user content
    SlicingThis element introduces a set of slices on DeviceUseStatement.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 6. DeviceUseStatement.extension:HealthcareProvider
      Slice NameHealthcareProvider
      Definition

      The healthcare provider at which use of the medical aid was initiated or where the aid was implanted.

      ShortHealthcareProvider
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(HCIM MedicalDevice Organization) (Extension Type: Reference)
      Alternate NamesZorgaanbieder
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      8. DeviceUseStatement.extension:HealthProfessional
      Slice NameHealthProfessional
      Definition

      The healthcare provider involved in the indication for use of the medical aid implant.

      ShortHealthProfessional
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(HCIM MedicalDevice Practitioner) (Extension Type: Reference)
      Alternate NamesZorgverlener
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      10. DeviceUseStatement.extension:HealthProfessional.url
      Definition

      Source of the definition for the extension code - a logical name or a URL.

      Shortidentifies the meaning of the extension
      Comments

      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

      Control1..1
      Typeuri
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/zib-MedicalDevice-Practitioner
      12. DeviceUseStatement.extension:HealthProfessional.value[x]
      Definition

      Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

      ShortValue of extension
      Control0..1
      TypeReference, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept
      [x] NoteSee Choice of Data Types for further information about how to use [x]
      SlicingThis element introduces a set of slices on DeviceUseStatement.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
      • type @ $this
      • 14. DeviceUseStatement.extension:HealthProfessional.value[x]:valueReference
        Slice NamevalueReference
        Definition

        The healthcare provider involved in the indication for use of the medical device implant.


        Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

        ShortHealthProfessionalValue of extension
        Control0..1
        TypeReference, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept
        [x] NoteSee Choice of Data Types for further information about how to use [x]
        Alternate NamesZorgverlener
        16. DeviceUseStatement.extension:reasonReference
        Slice NamereasonReference
        Definition

        An Extension

        ShortExtensionAdditional Content defined by implementations
        Control0..*
        TypeExtension
        18. DeviceUseStatement.extension:reasonReference.url
        Definition

        Source of the definition for the extension code - a logical name or a URL.

        Shortidentifies the meaning of the extension
        Comments

        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

        Control1..1
        Typeuri
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        Fixed ValuereasonReference
        20. DeviceUseStatement.extension:reasonReference.value[x]
        Definition

        Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

        ShortValue of extension
        Control0..1
        TypeReference, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept
        [x] NoteSee Choice of Data Types for further information about how to use [x]
        SlicingThis element introduces a set of slices on DeviceUseStatement.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
        • type @ $this
        • 22. DeviceUseStatement.extension:reasonReference.value[x]:valueReference
          Slice NamevalueReference
          Definition

          Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

          ShortValue of extension
          Control0..1
          TypeReference(HCIM HearingFunction), date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept
          [x] NoteSee Choice of Data Types for further information about how to use [x]
          24. DeviceUseStatement.modifierExtension
          Definition

          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.

          ShortExtensions that cannot be ignored
          Comments

          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.

          Control0..*
          TypeExtension
          Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
          Alternate Namesextensions, user content
          26. DeviceUseStatement.status
          Definition

          A code representing the patient or other source's judgment about the state of the device used that this statement is about. Generally this will be active or completed.

          Shortactive | completed | entered-in-error +
          Comments

          DeviceUseStatment is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for contains codes that assert the status of the use by the patient (for example, stopped or on hold) as well as codes that assert the status of the resource itself (for example, entered in error).

          This element is labeled as a modifier because the status contains the codes that mark the statement as not currently valid.

          Control1..1
          BindingThe codes SHALL be taken from DeviceUseStatementStatushttp://hl7.org/fhir/ValueSet/device-statement-status
          (required to http://hl7.org/fhir/ValueSet/device-statement-status)

          A coded concept indicating the current status of a the Device Usage

          Typecode
          Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          28. DeviceUseStatement.subject
          Definition

          The patient who used the device.

          ShortPatient using device
          Control1..1
          TypeReference(Group, nl-core-patient, Patient)
          30. DeviceUseStatement.device
          Definition

          The details of the device used.

          ShortReference to device used
          Control1..1
          TypeReference(http://nictiz.nl/fhir/StructureDefinition/zib-HearingAid-Product, Device)
          32. DeviceUseStatement.bodySite
          Definition

          The anatomical location of the hearing aid, such as: ‘left ear’.


          Indicates the site on the subject's body where the device was used ( i.e. the target site).

          ShortDeviceAnatomicalLocationTarget body site
          Control0..1
          BindingUnless not suitable, these codes SHALL be taken from For example codes, see LocatieGehoorapparaatCodelijsthttp://hl7.org/fhir/ValueSet/body-site
          (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.17.3--20171231000000)
          TypeCodeableConcept
          Requirements

          Knowing where the device is targeted is important for tracking if multiple sites are possible. If more information than just a code is required, use the extension http://hl7.org/fhir/StructureDefinition/body-site-instance.

          Alternate NamesAnatomischeLocatie, HulpmiddelAnatomischeLocatie
          34. DeviceUseStatement.bodySite.extension:Laterality
          Slice NameLaterality
          Definition

          Laterality adds information about body side to the anatomic location, e.g. left

          ShortLaterality
          Control0..1
          TypeExtension(BodySite Qualifier) (Extension Type: CodeableConcept)
          36. DeviceUseStatement.bodySite.extension:Laterality.url
          Definition

          Source of the definition for the extension code - a logical name or a URL.

          Shortidentifies the meaning of the extension
          Comments

          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

          Control1..1
          Typeuri
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/BodySite-Qualifier
          38. DeviceUseStatement.bodySite.extension:Laterality.value[x]
          Definition

          Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

          ShortValue of extension
          Control0..1
          TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
          [x] NoteSee Choice of Data Types for further information about how to use [x]
          SlicingThis element introduces a set of slices on DeviceUseStatement.bodySite.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
          • type @ $this
          • 40. DeviceUseStatement.bodySite.extension:Laterality.value[x]:valueCodeableConcept
            Slice NamevalueCodeableConcept
            Definition

            Qualifier to refine the anatomical location. These include qualifiers for laterality, relative location, directionality, number, and plane.


            Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

            ShortBodySite qualifierValue of extension
            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from For codes, see MedischHulpmiddelLateraliteitCodelijst
            (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.10.1.4--20171231000000)

            MedicalDeviceLateralityCodelist

            TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
            [x] NoteSee Choice of Data Types for further information about how to use [x]

            Guidance on how to interpret the contents of this table can be found here

            0. DeviceUseStatement
            Definition

            The medical aid used to help the patient hear.

            ShortHearingAid
            Control0..*
            Alternate NamesMedischHulpmiddel, HorenHulpmiddel
            Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
            dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
            dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
            dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
            2. DeviceUseStatement.id
            Definition

            The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

            ShortLogical id of this artifact
            Comments

            The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

            Control0..1
            Typeid
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            4. DeviceUseStatement.meta
            Definition

            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.

            ShortMetadata about the resource
            Control0..1
            TypeMeta
            Summarytrue
            6. DeviceUseStatement.implicitRules
            Definition

            A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

            ShortA set of rules under which this content was created
            Comments

            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.

            Control0..1
            Typeuri
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            8. DeviceUseStatement.language
            Definition

            The base language in which the resource is written.

            ShortLanguage of the resource content
            Comments

            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 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).

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from Common Languages
            (extensible to http://hl7.org/fhir/ValueSet/languages)

            A human language.

            Additional BindingsPurpose
            AllLanguagesMax Binding
            Typecode
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            10. DeviceUseStatement.text
            Definition

            A human-readable narrative that contains a summary of the resource, and may 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 "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

            ShortText summary of the resource, for human interpretation
            Comments

            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 "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

            Control0..1
            This element is affected by the following invariants: dom-1
            TypeNarrative
            Alternate Namesnarrative, html, xhtml, display
            12. DeviceUseStatement.contained
            Definition

            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.

            ShortContained, inline Resources
            Comments

            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.

            Control0..*
            TypeResource
            Alternate Namesinline resources, anonymous resources, contained resources
            14. DeviceUseStatement.extension
            Definition

            An Extension

            ShortExtension
            Control0..*
            TypeExtension
            SlicingThis element introduces a set of slices on DeviceUseStatement.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 16. DeviceUseStatement.extension:HealthcareProvider
              Slice NameHealthcareProvider
              Definition

              The healthcare provider at which use of the medical aid was initiated or where the aid was implanted.

              ShortHealthcareProvider
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(HCIM MedicalDevice Organization) (Extension Type: Reference)
              Alternate NamesZorgaanbieder
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              18. DeviceUseStatement.extension:HealthProfessional
              Slice NameHealthProfessional
              Definition

              The healthcare provider involved in the indication for use of the medical aid implant.

              ShortHealthProfessional
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(HCIM MedicalDevice Practitioner) (Extension Type: Reference)
              Alternate NamesZorgverlener
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              20. DeviceUseStatement.extension:HealthProfessional.id
              Definition

              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              Shortxml:id (or equivalent in JSON)
              Control0..1
              Typestring
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              22. DeviceUseStatement.extension:HealthProfessional.extension
              Definition

              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.

              ShortAdditional Content defined by implementations
              Comments

              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.

              Control0..*
              TypeExtension
              Alternate Namesextensions, user content
              SlicingThis element introduces a set of slices on DeviceUseStatement.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 24. DeviceUseStatement.extension:HealthProfessional.url
                Definition

                Source of the definition for the extension code - a logical name or a URL.

                Shortidentifies the meaning of the extension
                Comments

                The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                Control1..1
                Typeuri
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/zib-MedicalDevice-Practitioner
                26. DeviceUseStatement.extension:HealthProfessional.value[x]
                Definition

                Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                ShortValue of extension
                Control0..1
                TypeReference
                [x] NoteSee Choice of Data Types for further information about how to use [x]
                SlicingThis element introduces a set of slices on DeviceUseStatement.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
                • type @ $this
                • 28. DeviceUseStatement.extension:HealthProfessional.value[x]:valueReference
                  Slice NamevalueReference
                  Definition

                  The healthcare provider involved in the indication for use of the medical device implant.

                  ShortHealthProfessional
                  Control0..1
                  TypeReference
                  [x] NoteSee Choice of Data Types for further information about how to use [x]
                  Alternate NamesZorgverlener
                  30. DeviceUseStatement.extension:reasonReference
                  Slice NamereasonReference
                  Definition

                  An Extension

                  ShortExtension
                  Control0..*
                  TypeExtension
                  32. DeviceUseStatement.extension:reasonReference.id
                  Definition

                  unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  Shortxml:id (or equivalent in JSON)
                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  XML FormatIn the XML format, this property is represented as an attribute.
                  34. DeviceUseStatement.extension:reasonReference.extension
                  Definition

                  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.

                  ShortAdditional Content defined by implementations
                  Comments

                  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.

                  Control0..*
                  TypeExtension
                  Alternate Namesextensions, user content
                  SlicingThis element introduces a set of slices on DeviceUseStatement.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 36. DeviceUseStatement.extension:reasonReference.url
                    Definition

                    Source of the definition for the extension code - a logical name or a URL.

                    Shortidentifies the meaning of the extension
                    Comments

                    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                    Control1..1
                    Typeuri
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Fixed ValuereasonReference
                    38. DeviceUseStatement.extension:reasonReference.value[x]
                    Definition

                    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                    ShortValue of extension
                    Control0..1
                    TypeReference
                    [x] NoteSee Choice of Data Types for further information about how to use [x]
                    SlicingThis element introduces a set of slices on DeviceUseStatement.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
                    • type @ $this
                    • 40. DeviceUseStatement.extension:reasonReference.value[x]:valueReference
                      Slice NamevalueReference
                      Definition

                      Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                      ShortValue of extension
                      Control0..1
                      TypeReference(HCIM HearingFunction)
                      [x] NoteSee Choice of Data Types for further information about how to use [x]
                      42. DeviceUseStatement.modifierExtension
                      Definition

                      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.

                      ShortExtensions that cannot be ignored
                      Comments

                      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.

                      Control0..*
                      TypeExtension
                      Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                      Alternate Namesextensions, user content
                      44. DeviceUseStatement.identifier
                      Definition

                      An external identifier for this statement such as an IRI.

                      ShortExternal identifier for this record
                      NoteThis is a business identifier, not a resource identifier (see discussion)
                      Control0..*
                      TypeIdentifier
                      46. DeviceUseStatement.status
                      Definition

                      A code representing the patient or other source's judgment about the state of the device used that this statement is about. Generally this will be active or completed.

                      Shortactive | completed | entered-in-error +
                      Comments

                      DeviceUseStatment is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for contains codes that assert the status of the use by the patient (for example, stopped or on hold) as well as codes that assert the status of the resource itself (for example, entered in error).

                      This element is labeled as a modifier because the status contains the codes that mark the statement as not currently valid.

                      Control1..1
                      BindingThe codes SHALL be taken from DeviceUseStatementStatus
                      (required to http://hl7.org/fhir/ValueSet/device-statement-status)

                      A coded concept indicating the current status of a the Device Usage

                      Typecode
                      Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      48. DeviceUseStatement.subject
                      Definition

                      The patient who used the device.

                      ShortPatient using device
                      Control1..1
                      TypeReference(Group, nl-core-patient)
                      50. DeviceUseStatement.whenUsed
                      Definition

                      The time period over which the device was used.

                      ShortTime range defined by start and end date/time
                      Control0..1
                      TypePeriod
                      Alternate NamesTijdsduur gedefinieerd door start- en einddatum/tijd
                      52. DeviceUseStatement.whenUsed.id
                      Definition

                      unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                      Shortxml:id (or equivalent in JSON)
                      Control0..1
                      Typestring
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      54. DeviceUseStatement.whenUsed.extension
                      Definition

                      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.

                      ShortAdditional Content defined by implementations
                      Comments

                      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.

                      Control0..*
                      TypeExtension
                      Alternate Namesextensions, user content
                      SlicingThis element introduces a set of slices on DeviceUseStatement.whenUsed.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 56. DeviceUseStatement.whenUsed.start
                        Definition

                        The start date of the first use or implant of the medical aid. A ‘vague’ date, such as only the year, is permitted.

                        ShortStartDate
                        Comments

                        If the low element is missing, the meaning is that the low boundary is not known.

                        Control0..1
                        This element is affected by the following invariants: per-1
                        TypedateTime
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Alternate NamesBeginDatum
                        58. DeviceUseStatement.whenUsed.end
                        Definition

                        The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                        ShortEnd time with inclusive boundary, if not ongoing
                        Comments

                        The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

                        Control0..1
                        This element is affected by the following invariants: per-1
                        TypedateTime
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                        60. DeviceUseStatement.timing[x]
                        Definition

                        How often the device was used.

                        ShortHow often the device was used
                        Control0..1
                        TypeChoice of: Timing, Period, dateTime
                        [x] NoteSee Choice of Data Types for further information about how to use [x]
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        62. DeviceUseStatement.recordedOn
                        Definition

                        The time at which the statement was made/recorded.

                        ShortWhen statement was recorded
                        Control0..1
                        TypedateTime
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        64. DeviceUseStatement.source
                        Definition

                        Who reported the device was being used by the patient.

                        ShortWho made the statement
                        Control0..1
                        TypeReference(nl-core-patient, nl-core-practitioner, nl-core-relatedperson)
                        66. DeviceUseStatement.source.id
                        Definition

                        unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                        Shortxml:id (or equivalent in JSON)
                        Control0..1
                        Typestring
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        XML FormatIn the XML format, this property is represented as an attribute.
                        68. DeviceUseStatement.source.extension
                        Definition

                        An Extension

                        ShortExtension
                        Control0..*
                        TypeExtension
                        SlicingThis element introduces a set of slices on DeviceUseStatement.source.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 70. DeviceUseStatement.source.extension:practitionerRole
                          Slice NamepractitionerRole
                          Definition

                          Optional Extension Element - found in all resources.

                          ShortOptional Extensions Element
                          Control0..1
                          TypeExtension(PractitionerRole Reference) (Extension Type: Reference)
                          72. DeviceUseStatement.source.reference
                          Definition

                          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                          ShortLiteral reference, Relative, internal or absolute URL
                          Comments

                          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                          Control0..1
                          This element is affected by the following invariants: ref-1
                          Typestring
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          74. DeviceUseStatement.source.identifier
                          Definition

                          An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                          ShortLogical reference, when literal reference is not known
                          Comments

                          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control0..1
                          TypeIdentifier
                          Summarytrue
                          76. DeviceUseStatement.source.display
                          Definition

                          Plain text narrative that identifies the resource in addition to the resource reference.

                          ShortText alternative for the resource
                          Comments

                          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                          Control0..1
                          Typestring
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          78. DeviceUseStatement.device
                          Definition

                          The details of the device used.

                          ShortReference to device used
                          Control1..1
                          TypeReference(http://nictiz.nl/fhir/StructureDefinition/zib-HearingAid-Product)
                          80. DeviceUseStatement.indication
                          Definition

                          Reason or justification for the use of the device.

                          ShortWhy device was used
                          Control0..*
                          TypeCodeableConcept
                          82. DeviceUseStatement.indication.id
                          Definition

                          unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                          Shortxml:id (or equivalent in JSON)
                          Control0..1
                          Typestring
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          XML FormatIn the XML format, this property is represented as an attribute.
                          84. DeviceUseStatement.indication.extension
                          Definition

                          An Extension

                          ShortExtension
                          Control0..*
                          TypeExtension
                          SlicingThis element introduces a set of slices on DeviceUseStatement.indication.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 86. DeviceUseStatement.indication.extension:indication_Problem
                            Slice Nameindication_Problem
                            Definition

                            The medical reason for use of the medical device.

                            ShortIndication-Probleem
                            Control0..*
                            TypeExtension(HCIM MedicalDevice Problem) (Extension Type: Reference)
                            Alternate NamesIndicatie
                            88. DeviceUseStatement.indication.coding
                            Definition

                            A reference to a code defined by a terminology system.

                            ShortCode defined by a terminology system
                            Comments

                            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                            Control0..*
                            TypeCoding
                            Summarytrue
                            Requirements

                            Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                            90. DeviceUseStatement.indication.text
                            Definition

                            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                            ShortPlain text representation of the concept
                            Comments

                            Very often the text is the same as a displayName of one of the codings.

                            Control0..1
                            Typestring
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                            92. DeviceUseStatement.bodySite
                            Definition

                            The anatomical location of the hearing aid, such as: ‘left ear’.

                            ShortDeviceAnatomicalLocation
                            Control0..1
                            BindingUnless not suitable, these codes SHALL be taken from LocatieGehoorapparaatCodelijst
                            (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.17.3--20171231000000)
                            TypeCodeableConcept
                            Requirements

                            Knowing where the device is targeted is important for tracking if multiple sites are possible. If more information than just a code is required, use the extension http://hl7.org/fhir/StructureDefinition/body-site-instance.

                            Alternate NamesAnatomischeLocatie, HulpmiddelAnatomischeLocatie
                            94. DeviceUseStatement.bodySite.id
                            Definition

                            unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            Shortxml:id (or equivalent in JSON)
                            Control0..1
                            Typestring
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            XML FormatIn the XML format, this property is represented as an attribute.
                            96. DeviceUseStatement.bodySite.extension
                            Definition

                            An Extension

                            ShortExtension
                            Control0..*
                            TypeExtension
                            SlicingThis element introduces a set of slices on DeviceUseStatement.bodySite.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 98. DeviceUseStatement.bodySite.extension:Laterality
                              Slice NameLaterality
                              Definition

                              Laterality adds information about body side to the anatomic location, e.g. left

                              ShortLaterality
                              Control0..1
                              TypeExtension(BodySite Qualifier) (Extension Type: CodeableConcept)
                              100. DeviceUseStatement.bodySite.extension:Laterality.id
                              Definition

                              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              Shortxml:id (or equivalent in JSON)
                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              XML FormatIn the XML format, this property is represented as an attribute.
                              102. DeviceUseStatement.bodySite.extension:Laterality.extension
                              Definition

                              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.

                              ShortAdditional Content defined by implementations
                              Comments

                              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.

                              Control0..*
                              TypeExtension
                              Alternate Namesextensions, user content
                              SlicingThis element introduces a set of slices on DeviceUseStatement.bodySite.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 104. DeviceUseStatement.bodySite.extension:Laterality.url
                                Definition

                                Source of the definition for the extension code - a logical name or a URL.

                                Shortidentifies the meaning of the extension
                                Comments

                                The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                Control1..1
                                Typeuri
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/BodySite-Qualifier
                                106. DeviceUseStatement.bodySite.extension:Laterality.value[x]
                                Definition

                                Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                ShortValue of extension
                                Control0..1
                                TypeCodeableConcept
                                [x] NoteSee Choice of Data Types for further information about how to use [x]
                                SlicingThis element introduces a set of slices on DeviceUseStatement.bodySite.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
                                • type @ $this
                                • 108. DeviceUseStatement.bodySite.extension:Laterality.value[x]:valueCodeableConcept
                                  Slice NamevalueCodeableConcept
                                  Definition

                                  Qualifier to refine the anatomical location. These include qualifiers for laterality, relative location, directionality, number, and plane.

                                  ShortBodySite qualifier
                                  Control0..1
                                  BindingUnless not suitable, these codes SHALL be taken from MedischHulpmiddelLateraliteitCodelijst
                                  (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.10.1.4--20171231000000)

                                  MedicalDeviceLateralityCodelist

                                  TypeCodeableConcept
                                  [x] NoteSee Choice of Data Types for further information about how to use [x]
                                  110. DeviceUseStatement.bodySite.coding
                                  Definition

                                  A reference to a code defined by a terminology system.

                                  ShortCode defined by a terminology system
                                  Comments

                                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                  Control0..*
                                  TypeCoding
                                  Summarytrue
                                  Requirements

                                  Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                  112. DeviceUseStatement.bodySite.text
                                  Definition

                                  A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                  ShortPlain text representation of the concept
                                  Comments

                                  Very often the text is the same as a displayName of one of the codings.

                                  Control0..1
                                  Typestring
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Requirements

                                  The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                  114. DeviceUseStatement.note
                                  Definition

                                  Details about the device statement that were not represented at all or sufficiently in one of the attributes provided in a class. These may include for example a comment, an instruction, or a note associated with the statement.

                                  ShortAddition details (comments, instructions)
                                  Control0..*
                                  TypeAnnotation
                                  116. DeviceUseStatement.note.id
                                  Definition

                                  unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                  Shortxml:id (or equivalent in JSON)
                                  Control0..1
                                  Typestring
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  118. DeviceUseStatement.note.extension
                                  Definition

                                  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.

                                  ShortAdditional Content defined by implementations
                                  Comments

                                  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.

                                  Control0..*
                                  TypeExtension
                                  Alternate Namesextensions, user content
                                  SlicingThis element introduces a set of slices on DeviceUseStatement.note.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 120. DeviceUseStatement.note.author[x]
                                    Definition

                                    The individual responsible for making the annotation.

                                    ShortIndividual responsible for the annotation
                                    Control0..1
                                    TypeChoice of: Reference(Practitioner, Patient, RelatedPerson), string
                                    [x] NoteSee Choice of Data Types for further information about how to use [x]
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    122. DeviceUseStatement.note.time
                                    Definition

                                    Indicates when this particular annotation was made.

                                    ShortWhen the annotation was made
                                    Control0..1
                                    TypedateTime
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    124. DeviceUseStatement.note.text
                                    Definition

                                    Comment about use or information on the medical aid used.

                                    ShortComment
                                    Control1..1
                                    Typestring
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Alternate NamesToelichting