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 Wound MedicalDevice - Detailed Descriptions

Draft as of 2024-04-09

Definitions for the zib-Wound-MedicalDevice resource profile.

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

0. DeviceUseStatement
2. DeviceUseStatement.device
TypeReference(HCIM Wound MedicalDeviceProduct)

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

0. DeviceUseStatement
Definition

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.

ShortMedicalDeviceRecord of use of a device
Control0..*
Alternate NamesMedischHulpmiddel
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: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())
6. 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())
8. 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
10. 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
  • 12. 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
    14. 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
    16. 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
    18. DeviceUseStatement.subject
    Definition

    The patient who used the device.

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

    The details of the device used.

    ShortReference to device used
    Control1..1
    TypeReference(HCIM Wound MedicalDeviceProduct, Device)

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

    0. DeviceUseStatement
    Definition

    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.

    ShortMedicalDevice
    Control0..*
    Alternate NamesMedischHulpmiddel
    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.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
          32. 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
          34. 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
          36. DeviceUseStatement.subject
          Definition

          The patient who used the device.

          ShortPatient using device
          Control1..1
          TypeReference(Group, nl-core-patient)
          38. 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
          40. 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.
          42. 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
          • 44. 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
            46. 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
            48. 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
            50. 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
            52. 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)
            54. 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.
            56. 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
            • 58. 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)
              60. 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
              62. 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
              64. 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
              66. DeviceUseStatement.device
              Definition

              The details of the device used.

              ShortReference to device used
              Control1..1
              TypeReference(HCIM Wound MedicalDeviceProduct)
              68. DeviceUseStatement.indication
              Definition

              Reason or justification for the use of the device.

              ShortWhy device was used
              Control0..*
              TypeCodeableConcept
              70. 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.
              72. 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
              • 74. 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
                76. 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.

                78. 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.

                80. DeviceUseStatement.bodySite
                Definition

                Patient’s anatomical location of the medical device used.

                ShortAnatomicalLocation
                Control0..1
                BindingUnless not suitable, these codes SHALL be taken from HulpmiddelAnatomischeLocatieCodelijst
                (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.10.1.2--20171231000000)

                Patient’s anatomical location of the medical aid used.

                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
                82. 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.
                84. 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
                • 86. 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)
                  88. 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.
                  90. 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
                  • 92. 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
                    94. 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
                    • 96. 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]
                      98. 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.

                      100. 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.

                      102. 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
                      104. 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.
                      106. 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
                      • 108. 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
                        110. 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
                        112. 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