Advance Care Planning (PZP)
1.0.0-rc1 - trial-use

Advance Care Planning (PZP) - Downloaded Version 1.0.0-rc1 See the Directory of published versions

## Resource Profile: ACPMedicalDevice - Detailed Descriptions

Draft as of 2025-10-30

Definitions for the ACP-MedicalDevice resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

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

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.
Short | MedicalDeviceRecord of use of a device
Control | 0..*
Is Modifier | false
Alternate Names | MedischHulpmiddel, nl-core-MedicalDevice
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.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 or SHALL refer to the containing resource (`contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists())
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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A 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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. DeviceUseStatement.extension:healthProfessional
Slice Name | healthProfessional
Definition | Optional Extension Element - found in all resources.
Short | Optional Extensions Element
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ext MedicalDevice.HealthProfessional) (Extension Type: Reference(zib HealthProfessional PractitionerRole))
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. DeviceUseStatement.extension:healthProfessional.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://nictiz.nl/fhir/StructureDefinition/ext-MedicalDevice.HealthProfessional`
8. DeviceUseStatement.extension:healthProfessional.value[x]
Definition | The health professional involved in the indication for use of the medical device implant. Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | HealthProfessionalValue of extension
Comments | Each occurrence of the zib HealthProfessional is normally represented by two FHIR resources: a PractitionerRole resource (instance of nl-core-HealthProfessional-PractitionerRole) and a Practitioner resource (instance of nl-core-HealthProfessional-Practitioner). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance. In rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the nl-core-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Reference(nl core HealthProfessional PractitionerRole), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Alternate Names | Zorgverlener
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. DeviceUseStatement.extension:location
Slice Name | location
Definition | Optional Extension Element - found in all resources.
Short | Optional Extensions Element
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ext MedicalDevice.Location) (Extension Type: Reference(zib HealthcareProvider))
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
12. DeviceUseStatement.extension:location.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://nictiz.nl/fhir/StructureDefinition/ext-MedicalDevice.Location`
14. DeviceUseStatement.extension:location.value[x]
Definition | The healthcare provider at which use of the medical device was initiated or where the aid was implanted. Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | LocationValue of extension
Comments | Please note that this zib concept (Location::HealthcareProvider) is also mapped on the `Procedure.location` element in profile nl-core-Procedure-event. The reason for this is that this zib concept aligns with the Location::HealthcareProvider concept in zib Procedure (NL-CM:14.1.5), but only for the situation that the Procedure is about placing the implant which is described using this instance of zib MedicalDevice. In this situation, the current extension is redundant and it is advised to only use `Procedure.location` in profile nl-core-Procedure-event to represent the Location concept.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Reference(nl core HealthcareProvider), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Alternate Names | Locatie
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. DeviceUseStatement.extension:treatmentObjective
Slice Name | treatmentObjective
Definition | Indicates that the resource is related to either the measurement, achievement or progress towards the referenced goal. For example, a Procedure to exercise pertainsToGoal of losing weight.
Short | Pertains to goal
Comments | This extension is limited to subject-specific activity-related resources (events & intents). I.e. This can't be put on Goal or Patient. This association isn't for the purpose of goal management, but for things such as noting that a particular observation result, prescription or other activity is pertinent to the achievement (or possibly non-achievement) of the referenced goal.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Resource Pertains To Goal) (Extension Type: Reference(Goal))
Is Modifier | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. DeviceUseStatement.extension:treatmentObjective.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional 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.
Control | 0..0* This element is affected by the following invariants: ele-1
Type | Extension
Is Modifier | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `DeviceUseStatement.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
20. DeviceUseStatement.extension:treatmentObjective.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal`
22. DeviceUseStatement.extension:treatmentObjective.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Comments | Zib TreatmentObjective (represented by the Goal resource in FHIR) can use the data model of zib FunctionalOrMentalStatus to describe the desired treatment objective, which in turn may refer zib MedicalDevice to indicate the intent to use that device for reaching the treatment objective. In FHIR, the modeling deviates somewhat from this approach: Both zib TreatmentObjective and the desired zib FunctionalOrMentalStatus are represented using the nl-core-TreatmentObjective profile on the Goal resource. The reference from TreatmentObjective::FunctionalOrMentalStatus::MedicalDevice is in the opposite direction, to the Goal resource. This extension may thus be used to represent the link zib TreatmentObjective -> zib FunctionalOrMentalStatus -> zib MedicalDevice. In this situation, it is expected that `DeviceUseStatement.status` is set to intended.
Control | 10..1 This element is affected by the following invariants: ele-1
Type | Reference(Goal, nl core TreatmentObjective), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. DeviceUseStatement.extension:encounter
Slice Name | encounter
Definition | An extension to link the Encounter during which the Consent, Goal or DeviceUseStatement was created or to which the creation is tightly associated.
Short | ext Encounter Reference
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ext Encounter Reference) (Extension Type: Reference(Encounter))
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
26. DeviceUseStatement.extension:encounter.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional 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.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `DeviceUseStatement.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
28. DeviceUseStatement.extension:encounter.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference`
30. DeviceUseStatement.extension:encounter.value[x]
Definition | The Encounter during which this resource was created or to which the creation is tightly associated. Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | EncounterValue of extension
Comments | This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. completing the administrative registration after the encounter).
Control | 0..1
Type | Reference(Encounter), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions 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.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `DeviceUseStatement.modifierExtension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
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.
Short | active | completed | entered-in-error +
Comments | This element is implictly mapped to the zib concepts NL-CM:10.1.11 (StartDate) and NL-CM:10.1.14 (EndDate). Unless the status is explicitly recorded, the following guidance applies: When StartDate is in the future, `.status` will usually be set to intended. When StartDate is in the past and EndDate has a value and in the future or EndDate has no value, `.status` will usually be set to active. When EndDate has a value and is in the past, `.status` will usually be set to completed. 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.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | The codes SHALL be taken from DeviceUseStatementStatus http://hl7.org/fhir/ValueSet/device-statement-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/device-statement-status|4.0.1` ) A coded concept indicating the current status of the Device Usage.
Type | code
Is Modifier | true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. DeviceUseStatement.subject
Definition | The patient who used the device.
Short | Patient using device
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Reference(Patient, Patient, Group)
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. DeviceUseStatement.derivedFrom
Definition | Allows linking the DeviceUseStatement to the underlying Request, or to other information that supports or is used to derive the DeviceUseStatement.
Short | Supporting information
Comments | The most common use cases for deriving a DeviceUseStatement comes from creating it from a request or from an observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the DeviceUseStatement from.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Reference(ServiceRequest, Procedure, Claim, Observation, QuestionnaireResponse, DocumentReference)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `DeviceUseStatement.derivedFrom`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
40. DeviceUseStatement.derivedFrom:procedure-request
Slice Name | procedure-request
Definition | The procedure which has the purpose of placing this product in or on the body. Allows linking the DeviceUseStatement to the underlying Request, or to other information that supports or is used to derive the DeviceUseStatement.
Short | ProcedureSupporting information
Comments | Note 1: on a functional level, zib Procedure references zib MedicalDevice, but in FHIR this direction is reversed. Note 2: zib Procedure can represent a requested or (to be) performed procedure. This slice represents requested procedures, while slice `procedure-event` represents performed procedures. The most common use cases for deriving a DeviceUseStatement comes from creating it from a request or from an observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the DeviceUseStatement from.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Reference(nl core Procedure request, ServiceRequest, Procedure, Claim, Observation, QuestionnaireResponse, DocumentReference)
Is Modifier | false
Summary | true
Alternate Names | Verrichting
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. DeviceUseStatement.derivedFrom:procedure-event
Slice Name | procedure-event
Definition | The procedure which has the purpose of placing this product in or on the body. Allows linking the DeviceUseStatement to the underlying Request, or to other information that supports or is used to derive the DeviceUseStatement.
Short | ProcedureSupporting information
Comments | Note 1: on a functional level, zib Procedure references zib MedicalDevice, but in FHIR this direction is reversed. Note 2: zib Procedure can represent a requested or (to be) performed procedure. This slice represents performed procedures, while slice `procedure-request` represents requested procedures. The most common use cases for deriving a DeviceUseStatement comes from creating it from a request or from an observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the DeviceUseStatement from.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Reference(nl core Procedure event, ServiceRequest, Procedure, Claim, Observation, QuestionnaireResponse, DocumentReference)
Is Modifier | false
Summary | true
Alternate Names | Verrichting
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. DeviceUseStatement.timing[x]
Definition | How often the device was used.
Short | How often the device was used
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Choice of: Timing, Period, dateTime
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `DeviceUseStatement.timing[x]`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: type @ $this
46. DeviceUseStatement.timing[x]:timingPeriod
Slice Name | timingPeriod
Definition | How often the device was used.
Short | How often the device was used
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Period, dateTime, Timing
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. DeviceUseStatement.timing[x]:timingPeriod.start
Definition | The start date of the first use or implant of the medical device. A "vague" date, such as only the year, is permitted. The start of the period. The boundary is inclusive.
Short | StartDateStarting time with inclusive boundary
Comments | If the low element is missing, the meaning is that the low boundary is not known.
Control | 0..1 This element is affected by the following invariants: ele-1, per-1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Summary | true
Alternate Names | BeginDatum
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. DeviceUseStatement.timing[x]:timingPeriod.end
Definition | The end date of the last use or explant of the medical device. A "vague" date, such as only the year, is permitted. The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. 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.
Short | EndDateEnd 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 an end value of 2012-02-03.
Control | 0..1 This element is affected by the following invariants: ele-1, per-1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Summary | true
Alternate Names | EindDatum
Meaning if Missing | If the end of the period is missing, it means that the period is ongoing
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. DeviceUseStatement.device
Definition | The details of the device used.
Short | Reference to device used
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Reference(MedicalDevice Product ICD, nl core MedicalDevice.Product, Device)
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. DeviceUseStatement.reasonReference
Definition | Indicates another resource whose existence justifies this DeviceUseStatement.
Short | Why was DeviceUseStatement performed?
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Reference(Condition, Observation, DiagnosticReport, DocumentReference, Media)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `DeviceUseStatement.reasonReference`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
56. DeviceUseStatement.reasonReference:indication
Slice Name | indication
Definition | The medical reason for use of the medical device. Indicates another resource whose existence justifies this DeviceUseStatement.
Short | IndicationWhy was DeviceUseStatement performed?
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Reference(nl core Problem, Condition, Observation, DiagnosticReport, DocumentReference, Media)
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Summary | true
Alternate Names | Indicatie
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. DeviceUseStatement.reasonReference:stoma
Slice Name | stoma
Definition | Indicates another resource whose existence justifies this DeviceUseStatement.
Short | StomaWhy was DeviceUseStatement performed?
Comments | Please note that on a functional level, zib Stoma references zib MedicalDevice, but in FHIR this direction is reversed.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Reference(nl core Stoma, Condition, Observation, DiagnosticReport, DocumentReference, Media)
Is Modifier | false
Summary | true
Alternate Names | Stoma
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. DeviceUseStatement.bodySite
Definition | Localisation on/in the body. Indicates the anotomic location on the subject's body where the device was used ( i.e. the target).
Short | LocationTarget body site
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | The codes SHALL be taken from For example codes, see LocatieCodelijsten (2020-09-01T00:00:00)http://hl7.org/fhir/ValueSet/body-site|4.0.1 (required to `http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.11--20200901000000|2020-09-01T00:00:00` ) Codes describing anatomical locations. May include laterality.
Type | CodeableConcept(nl core AnatomicalLocation)
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Summary | true
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/bodySite. 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/bodySite.
Alternate Names | Locatie, AnatomischeLocatie, nl-core-AnatomicalLocation
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. DeviceUseStatement.bodySite.extension:laterality
Slice Name | laterality
Definition | Optional Extension Element - found in all resources.
Short | Optional Extensions Element
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ext AnatomicalLocation.Laterality) (Extension Type: CodeableConcept)
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
64. DeviceUseStatement.bodySite.extension:laterality.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://nictiz.nl/fhir/StructureDefinition/ext-AnatomicalLocation.Laterality`
66. DeviceUseStatement.bodySite.extension:laterality.value[x]
Definition | Laterality adds information about body site to the anatomic location, e.g. left. Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | LateralityValue of extension
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | The codes SHALL be taken from For codes, see LateraliteitCodelijst (2020-09-01T00:00:00) (required to `http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.20.7.2--20200901000000|2020-09-01T00:00:00` )
Type | CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Alternate Names | Lateraliteit
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. 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.
Short | Addition details (comments, instructions)
Comments | For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
Control | 0..1* This element is affected by the following invariants: ele-1
Type | Annotation
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
70. DeviceUseStatement.note.text
Definition | Comment about use or information on the medical device used. The text of the annotation in markdown format.
Short | CommentThe annotation - text content (as markdown)
Comments | Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/
Control | 1..1 This element is affected by the following invariants: ele-1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Summary | true
Alternate Names | Toelichting
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

0. DeviceUseStatement
2. DeviceUseStatement.extension:healthProfessional
Slice Name | healthProfessional
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
4. DeviceUseStatement.extension:healthProfessional.value[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
6. DeviceUseStatement.extension:location
Slice Name | location
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
8. DeviceUseStatement.extension:location.value[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
10. DeviceUseStatement.extension:encounter
Slice Name | encounter
Control | 0..1
Type | Extension(ext Encounter Reference) (Extension Type: Reference(Encounter))
12. DeviceUseStatement.extension:encounter.value[x]
Type | Reference(Encounter)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
14. DeviceUseStatement.subject
Type | Reference(Patient)
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
16. DeviceUseStatement.timing[x]:timingPeriod
Slice Name | timingPeriod
Type | Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
18. DeviceUseStatement.timing[x]:timingPeriod.start
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
20. DeviceUseStatement.timing[x]:timingPeriod.end
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
22. DeviceUseStatement.device
Type | Reference(MedicalDevice Product ICD, nl core MedicalDevice.Product)
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
24. DeviceUseStatement.reasonReference:indication
Slice Name | indication
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
26. DeviceUseStatement.bodySite
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
28. DeviceUseStatement.bodySite.extension:laterality
Slice Name | laterality
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
30. DeviceUseStatement.bodySite.extension:laterality.value[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
32. DeviceUseStatement.note
34. DeviceUseStatement.note.text
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter

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

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.
Short | MedicalDevice
Control | 0..*
Alternate Names | MedischHulpmiddel, nl-core-MedicalDevice
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.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 or SHALL refer to the containing resource (`contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.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.
Short | Logical 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.
Control | 0..1
Type | id
Summary | true
4. DeviceUseStatement.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Short | Metadata about the resource
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Meta
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A 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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
8. DeviceUseStatement.language
Definition | The base language in which the resource is written.
Short | Language 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).
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. DeviceUseStatement.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "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.
Short | Text 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 information is added later.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Narrative
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
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.
Short | Contained, 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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Control | 0..*
Type | Resource
Alternate Names | inline resources, anonymous resources, contained resources
14. DeviceUseStatement.extension
Definition | May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional 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.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `DeviceUseStatement.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
16. DeviceUseStatement.extension:healthProfessional
Slice Name | healthProfessional
Definition | Optional Extension Element - found in all resources.
Short | Optional Extensions Element
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ext MedicalDevice.HealthProfessional) (Extension Type: Reference(zib HealthProfessional PractitionerRole))
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
18. 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.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
XML Format | In the XML format, this property is represented as an attribute.
20. DeviceUseStatement.extension:healthProfessional.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional 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.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `DeviceUseStatement.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
22. DeviceUseStatement.extension:healthProfessional.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://nictiz.nl/fhir/StructureDefinition/ext-MedicalDevice.HealthProfessional`
24. DeviceUseStatement.extension:healthProfessional.value[x]
Definition | The health professional involved in the indication for use of the medical device implant.
Short | HealthProfessional
Comments | Each occurrence of the zib HealthProfessional is normally represented by two FHIR resources: a PractitionerRole resource (instance of nl-core-HealthProfessional-PractitionerRole) and a Practitioner resource (instance of nl-core-HealthProfessional-Practitioner). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance. In rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the nl-core-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Reference(nl core HealthProfessional PractitionerRole)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Alternate Names | Zorgverlener
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. DeviceUseStatement.extension:location
Slice Name | location
Definition | Optional Extension Element - found in all resources.
Short | Optional Extensions Element
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ext MedicalDevice.Location) (Extension Type: Reference(zib HealthcareProvider))
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
28. DeviceUseStatement.extension:location.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
XML Format | In the XML format, this property is represented as an attribute.
30. DeviceUseStatement.extension:location.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional 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.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `DeviceUseStatement.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
32. DeviceUseStatement.extension:location.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://nictiz.nl/fhir/StructureDefinition/ext-MedicalDevice.Location`
34. DeviceUseStatement.extension:location.value[x]
Definition | The healthcare provider at which use of the medical device was initiated or where the aid was implanted.
Short | Location
Comments | Please note that this zib concept (Location::HealthcareProvider) is also mapped on the `Procedure.location` element in profile nl-core-Procedure-event. The reason for this is that this zib concept aligns with the Location::HealthcareProvider concept in zib Procedure (NL-CM:14.1.5), but only for the situation that the Procedure is about placing the implant which is described using this instance of zib MedicalDevice. In this situation, the current extension is redundant and it is advised to only use `Procedure.location` in profile nl-core-Procedure-event to represent the Location concept.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Reference(nl core HealthcareProvider)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Alternate Names | Locatie
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
36. DeviceUseStatement.extension:treatmentObjective
Slice Name | treatmentObjective
Definition | Indicates that the resource is related to either the measurement, achievement or progress towards the referenced goal. For example, a Procedure to exercise pertainsToGoal of losing weight.
Short | Pertains to goal
Comments | This extension is limited to subject-specific activity-related resources (events & intents). I.e. This can't be put on Goal or Patient. This association isn't for the purpose of goal management, but for things such as noting that a particular observation result, prescription or other activity is pertinent to the achievement (or possibly non-achievement) of the referenced goal.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Resource Pertains To Goal) (Extension Type: Reference(Goal))
Is Modifier | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
38. DeviceUseStatement.extension:treatmentObjective.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
XML Format | In the XML format, this property is represented as an attribute.
40. DeviceUseStatement.extension:treatmentObjective.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional 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.
Control | 0..0 This element is affected by the following invariants: ele-1
Type | Extension
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `DeviceUseStatement.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
42. DeviceUseStatement.extension:treatmentObjective.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal`
44. DeviceUseStatement.extension:treatmentObjective.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Comments | Zib TreatmentObjective (represented by the Goal resource in FHIR) can use the data model of zib FunctionalOrMentalStatus to describe the desired treatment objective, which in turn may refer zib MedicalDevice to indicate the intent to use that device for reaching the treatment objective. In FHIR, the modeling deviates somewhat from this approach: Both zib TreatmentObjective and the desired zib FunctionalOrMentalStatus are represented using the nl-core-TreatmentObjective profile on the Goal resource. The reference from TreatmentObjective::FunctionalOrMentalStatus::MedicalDevice is in the opposite direction, to the Goal resource. This extension may thus be used to represent the link zib TreatmentObjective -> zib FunctionalOrMentalStatus -> zib MedicalDevice. In this situation, it is expected that `DeviceUseStatement.status` is set to intended.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Reference(Goal, nl core TreatmentObjective)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
46. DeviceUseStatement.extension:encounter
Slice Name | encounter
Definition | An extension to link the Encounter during which the Consent, Goal or DeviceUseStatement was created or to which the creation is tightly associated.
Short | ext Encounter Reference
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ext Encounter Reference) (Extension Type: Reference(Encounter))
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
48. DeviceUseStatement.extension:encounter.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
50. DeviceUseStatement.extension:encounter.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `DeviceUseStatement.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
52. DeviceUseStatement.extension:encounter.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference`
54. DeviceUseStatement.extension:encounter.value[x]
Definition | The Encounter during which this resource was created or to which the creation is tightly associated.
Short | Encounter
Comments | This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. completing the administrative registration after the encounter).
Control | 0..1
Type | Reference(Encounter)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
56. 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions 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.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `DeviceUseStatement.modifierExtension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
58. DeviceUseStatement.identifier
Definition | An external identifier for this statement such as an IRI.
Short | External identifier for this record
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..* This element is affected by the following invariants: ele-1
Type | Identifier
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
60. DeviceUseStatement.basedOn
Definition | A plan, proposal or order that is fulfilled in whole or in part by this DeviceUseStatement.
Short | Fulfills plan, proposal or order
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Reference(ServiceRequest)
Summary | true
Requirements | Allows tracing of authorization for the DeviceUseStatement and tracking whether proposals/recommendations were acted upon.
Alternate Names | fulfills
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
62. 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.
Short | active | completed | entered-in-error +
Comments | This element is implictly mapped to the zib concepts NL-CM:10.1.11 (StartDate) and NL-CM:10.1.14 (EndDate). Unless the status is explicitly recorded, the following guidance applies: When StartDate is in the future, `.status` will usually be set to intended. When StartDate is in the past and EndDate has a value and in the future or EndDate has no value, `.status` will usually be set to active. When EndDate has a value and is in the past, `.status` will usually be set to completed.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | The codes SHALL be taken from DeviceUseStatementStatus (required to `http://hl7.org/fhir/ValueSet/device-statement-status|4.0.1` ) A coded concept indicating the current status of the Device Usage.
Type | code
Is Modifier | true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
64. DeviceUseStatement.subject
Definition | The patient who used the device.
Short | Patient using device
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Reference(Patient)
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
66. DeviceUseStatement.derivedFrom
Definition | Allows linking the DeviceUseStatement to the underlying Request, or to other information that supports or is used to derive the DeviceUseStatement.
Short | Supporting information
Comments | The most common use cases for deriving a DeviceUseStatement comes from creating it from a request or from an observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the DeviceUseStatement from.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Reference(ServiceRequest, Procedure, Claim, Observation, QuestionnaireResponse, DocumentReference)
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
Slicing | This element introduces a set of slices on `DeviceUseStatement.derivedFrom`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
68. DeviceUseStatement.derivedFrom:procedure-request
Slice Name | procedure-request
Definition | The procedure which has the purpose of placing this product in or on the body.
Short | Procedure
Comments | Note 1: on a functional level, zib Procedure references zib MedicalDevice, but in FHIR this direction is reversed. Note 2: zib Procedure can represent a requested or (to be) performed procedure. This slice represents requested procedures, while slice `procedure-event` represents performed procedures.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Reference(nl core Procedure request)
Summary | true
Alternate Names | Verrichting
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
70. DeviceUseStatement.derivedFrom:procedure-event
Slice Name | procedure-event
Definition | The procedure which has the purpose of placing this product in or on the body.
Short | Procedure
Comments | Note 1: on a functional level, zib Procedure references zib MedicalDevice, but in FHIR this direction is reversed. Note 2: zib Procedure can represent a requested or (to be) performed procedure. This slice represents performed procedures, while slice `procedure-request` represents requested procedures.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Reference(nl core Procedure event)
Summary | true
Alternate Names | Verrichting
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
72. DeviceUseStatement.timing[x]
Definition | How often the device was used.
Short | How often the device was used
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Choice of: Timing, Period, dateTime
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `DeviceUseStatement.timing[x]`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: type @ $this
74. DeviceUseStatement.timing[x]:timingPeriod
Slice Name | timingPeriod
Definition | How often the device was used.
Short | How often the device was used
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
76. DeviceUseStatement.timing[x]:timingPeriod.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
XML Format | In the XML format, this property is represented as an attribute.
78. DeviceUseStatement.timing[x]:timingPeriod.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional 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.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `DeviceUseStatement.timing[x].extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
80. DeviceUseStatement.timing[x]:timingPeriod.start
Definition | The start date of the first use or implant of the medical device. A "vague" date, such as only the year, is permitted.
Short | StartDate
Comments | If the low element is missing, the meaning is that the low boundary is not known.
Control | 0..1 This element is affected by the following invariants: ele-1, per-1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Summary | true
Alternate Names | BeginDatum
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
82. DeviceUseStatement.timing[x]:timingPeriod.end
Definition | The end date of the last use or explant of the medical device. A "vague" date, such as only the year, is permitted.
Short | EndDate
Comments | The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.
Control | 0..1 This element is affected by the following invariants: ele-1, per-1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Summary | true
Alternate Names | EindDatum
Meaning if Missing | If the end of the period is missing, it means that the period is ongoing
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
84. DeviceUseStatement.recordedOn
Definition | The time at which the statement was made/recorded.
Short | When statement was recorded
Control | 0..1 This element is affected by the following invariants: ele-1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
86. DeviceUseStatement.source
Definition | Who reported the device was being used by the patient.
Short | Who made the statement
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Reference(Patient, Practitioner, PractitionerRole, RelatedPerson)
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
88. DeviceUseStatement.device
Definition | The details of the device used.
Short | Reference to device used
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Reference(MedicalDevice Product ICD, nl core MedicalDevice.Product)
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
90. DeviceUseStatement.reasonCode
Definition | Reason or justification for the use of the device.
Short | Why device was used
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Control | 0..* This element is affected by the following invariants: ele-1
Type | CodeableConcept
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
92. DeviceUseStatement.reasonReference
Definition | Indicates another resource whose existence justifies this DeviceUseStatement.
Short | Why was DeviceUseStatement performed?
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Reference(Condition, Observation, DiagnosticReport, DocumentReference, Media)
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
Slicing | This element introduces a set of slices on `DeviceUseStatement.reasonReference`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
94. DeviceUseStatement.reasonReference:indication
Slice Name | indication
Definition | The medical reason for use of the medical device.
Short | Indication
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Reference(nl core Problem)
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Summary | true
Alternate Names | Indicatie
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
96. DeviceUseStatement.reasonReference:stoma
Slice Name | stoma
Definition | Indicates another resource whose existence justifies this DeviceUseStatement.
Short | Stoma
Comments | Please note that on a functional level, zib Stoma references zib MedicalDevice, but in FHIR this direction is reversed.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Reference(nl core Stoma)
Summary | true
Alternate Names | Stoma
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
98. DeviceUseStatement.bodySite
Definition | Localisation on/in the body.
Short | Location
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | The codes SHALL be taken from LocatieCodelijsten (2020-09-01T00:00:00) (required to `http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.11--20200901000000|2020-09-01T00:00:00` ) Codes describing anatomical locations. May include laterality.
Type | CodeableConcept(nl core AnatomicalLocation)
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Summary | true
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/bodySite.
Alternate Names | Locatie, AnatomischeLocatie, nl-core-AnatomicalLocation
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
100. 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.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
XML Format | In the XML format, this property is represented as an attribute.
102. DeviceUseStatement.bodySite.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional 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.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `DeviceUseStatement.bodySite.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
104. DeviceUseStatement.bodySite.extension:laterality
Slice Name | laterality
Definition | Optional Extension Element - found in all resources.
Short | Optional Extensions Element
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ext AnatomicalLocation.Laterality) (Extension Type: CodeableConcept)
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
106. 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.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
XML Format | In the XML format, this property is represented as an attribute.
108. DeviceUseStatement.bodySite.extension:laterality.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional 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.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `DeviceUseStatement.bodySite.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
110. DeviceUseStatement.bodySite.extension:laterality.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://nictiz.nl/fhir/StructureDefinition/ext-AnatomicalLocation.Laterality`
112. DeviceUseStatement.bodySite.extension:laterality.value[x]
Definition | Laterality adds information about body site to the anatomic location, e.g. left.
Short | Laterality
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | The codes SHALL be taken from LateraliteitCodelijst (2020-09-01T00:00:00) (required to `http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.20.7.2--20200901000000|2020-09-01T00:00:00` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Alternate Names | Lateraliteit
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
114. DeviceUseStatement.bodySite.coding
Definition | A reference to a code defined by a terminology system.
Short | Code 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.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Coding
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
116. 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.
Short | Plain text representation of the concept
Comments | Very often the text is the same as a displayName of one of the codings.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
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.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
118. 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.
Short | Addition details (comments, instructions)
Comments | For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Annotation
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
120. 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.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
XML Format | In the XML format, this property is represented as an attribute.
122. DeviceUseStatement.note.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional 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.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `DeviceUseStatement.note.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
124. DeviceUseStatement.note.author[x]
Definition | The individual responsible for making the annotation.
Short | Individual responsible for the annotation
Comments | Organization is used when there's no need for specific attribution as to who made the comment.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Choice of: Reference(Practitioner, Patient, RelatedPerson, Organization), string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
126. DeviceUseStatement.note.time
Definition | Indicates when this particular annotation was made.
Short | When the annotation was made
Control | 0..1 This element is affected by the following invariants: ele-1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
128. DeviceUseStatement.note.text
Definition | Comment about use or information on the medical device used.
Short | Comment
Comments | Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/
Control | 1..1 This element is affected by the following invariants: ele-1
Type | markdown
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Summary | true
Alternate Names | Toelichting
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)