type: resource-definitionsresource: DeviceAlert

DeviceAlert Definitions

DeviceAlert

Documentation of an alert (a.k.a. alarm) generated by a device indicating a noteworthy condition

Definition: Describes a noteworthy condition or occurrence determined to exist by a device.

Comments: The DeviceAlert resource is derived from the ISO/IEEE 11073-10201 Domain Information Model standard, but is more widely applicable.

Cardinality: 0..*

Summary: false

Mappings: w5=administrative.device; workflow=Event; DIM=AlertCondition, AlertState; BICEPS=AlertConditionDescriptor, AlertSignalState, AlertConditionState

DeviceAlert.identifier

Business identifier for this device alert

Definition: Business identifiers assigned to this alert, by the source device, gateway software, manufacturers, or other systems or organizations. These identifiers remain constant as the resource is updated and propagates from server to server.

Comments: Note: This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For identifiers assigned to an alert by the device or gateway software, the system element of the identifier might be set to an identifier of the device.

Requirements: Allows identification of the device alert as it is known by various participating systems and in a way that remains consistent across servers.

Cardinality: 0..*

Type: Identifier

Summary: true

Mappings: w5=FiveWs.identifier; workflow=Event.identifier; DIM=AlertCondition/alert-info-id; BICEPS=AlertOccurrenceIdentifier

DeviceAlert.procedure

Procedure during which the alert occurred

Definition: The procedure (or procedures) during which the alert condition was raised.

Cardinality: 0..*

Type: Reference(Procedure)

Summary: true

Mappings: workflow=Event.partOf

DeviceAlert.status

in-progress | completed | entered-in-error | unknown

Definition: The current state of the device alert.

Comments: Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is.

Cardinality: 1..1

Type: code

Binding: required:devicealert-status

Summary: true

Is Modifier: true (Reason: This element is labeled as a modifier because it has a potential code that indicates the Alert was entered in error.)

Mappings: w5=FiveWs.status; workflow=Event.status; DIM=AlertState

DeviceAlert.category

High level categorization of device alert

Definition: Partitions the device alert into one or more categories that can be used to filter searching, to govern access control and/or to guide system behavior.

Comments: Categorization might be done automatically (inferred by code) or manually by user assertion. The absence of a category may limit the ability to determine when the element should be handled, so strong consideration should be given to how systems will be able to determine category values for legacy data and how data that cannot be categorized will be handled. As well, some categories might not be mutually exclusive, so systems should prepare for multiple declared categories - even within a single category 'axis'.

Cardinality: 0..*

Type: CodeableConcept

Binding: example:devicealert-category

Summary: true

Mappings: w5=FiveWs.class; workflow=Event.category

DeviceAlert.type

physiological | technical

Cardinality: 0..1

Type: CodeableConcept

Binding: extensible:devicealert-type

Summary: false

Mappings: w5=FiveWs.class; DIM=AlertCondition/alert-type; BICEPS=AlertConditionDescriptor/Kind

DeviceAlert.priority

high | medium | low | info

Definition: The alert priority is usually reported by the source device. A priority of info SHOULD indicate that the alert is “for information only” and urgent action is not required. The element MAY be omitted if the priority is unknown.

Cardinality: 0..1

Type: CodeableConcept

Binding: extensible:devicealert-priority

Summary: true

Mappings: w5=FiveWs.grade; DIM=AlertCondition/alert-type; BICEPS=If present, AlertConditionState/ActualPriority; otherwise AlertConditionDescriptor/Priority

DeviceAlert.code

The meaning of the alert

Definition: A code that indicates the specific condition that triggered the alert.

Cardinality: 1..1

Type: CodeableConcept

Binding: preferred:devicealert-condition

Summary: true

Mappings: w5=FiveWs.what[x]; workflow=Event.code; DIM=AlertCondition/alert-code; BICEPS=AlertConditionDescriptor/Type

DeviceAlert.subject

Who or what the alert is about

Requirements: Links the device alert to the appropriate subject context. May also affect access control.

Cardinality: 1..1

Type: Reference(Patient, Device, BiologicallyDerivedProduct, Group, Location, Medication, NutritionProduct, Specimen)

Summary: true

Mappings: w5=FiveWs.subject; workflow=Event.subject

DeviceAlert.encounter

Encounter during which the alert condition occurred

Definition: The Encounter during which the alert condition was raised.

Requirements: Links the device alert to the Encounter context. May also affect access control.

Cardinality: 0..1

Type: Reference(Encounter)

Summary: true

Mappings: w5=FiveWs.context; workflow=Event.encounter

DeviceAlert.presence

Whether the alert condition is currently active

Cardinality: 1..1

Type: boolean

Summary: true

Mappings: BICEPS=AlertConditionState/Presence

DeviceAlert.occurrence[x]

When the alert condition occurred/is occurring

Definition: This element is used to record the date or time period when the alert condition did occur or is occurring.

Comments: This element is used to record the time period during which the alert condition is or was active. The status code allows differentiation of whether the timing reflects a historic event or an ongoing event. A date/time value SHOULD be used for instantaneous conditions. Partial date/time values are ambiguous about whether they represent the condition occurring at some point in the partially specified period, or for all of the period, and (absent additional guidance) SHOULD be avoided. Ongoing events SHOULD not include a Period upper bound.

Cardinality: 0..1

Type: dateTime, Period

Summary: true

Mappings: w5=FiveWs.done[x]; workflow=Event.occurrence[x]; BICEPS=AlertConditionState/DeterminationTime

DeviceAlert.device

The Device (or DeviceMetric) that detected the alert condition

Definition: Indicates the device that detected the alert condition. The device could be a top-level Device or component Device (such as an MDS, VMD, or Channel); or might identify the specific DeviceMetric of a Device (e.g., a heart rate reading) that was in an alert condition.

Cardinality: 0..1

Type: Reference(Device, DeviceMetric)

Summary: true

Mappings: w5=FiveWs.author; workflow=Event.product; DIM=AlertCondition/alert-source; BICEPS=AlertConditionDescriptor/Source

DeviceAlert.acknowledged

Whether the alert condition has been acknowledged

Definition: An indication of whether (true) or not (false) the alert condition has been acknowledged.

Meaning if Missing: If absent, no inference SHOULD be made about whether the alert condition has been acknowledged.

Cardinality: 0..1

Type: boolean

Summary: false

DeviceAlert.acknowledgedBy

Who acknowledged the alert condition

Definition: An indication of who or what acknowledged the alert condition.

Cardinality: 0..1

Type: Reference(Patient, Device, Practitioner, PractitionerRole, RelatedPerson)

Summary: false

Mappings: w5=FiveWs.actor; workflow=Event.actor

DeviceAlert.location

Location of the subject when the alert was raised

Definition: The principal physical location of the subject at the time the alert condition occurred. This could be different from the location of the alerting device at that time, and from the current location of either the subject or the alert condition detecting device.

Requirements: Provides context around the alert occurrence (e.g. if it occurred inside or outside a dedicated healthcare setting).

Cardinality: 0..1

Type: Reference(Location)

Summary: true

Mappings: w5=FiveWs.where[x]; workflow=Event.location

DeviceAlert.derivedFrom

The value causing the alert condition

Cardinality: 0..*

Type: BackboneElement

Summary: false

Mappings: w5=FiveWs.why[x]

DeviceAlert.derivedFrom.observation

The Observation having a value causing the alert condition

Definition: Indicates the Observation whose value is causing the alert condition; or, if component is present, the Observation with a component causing the alert condition.

Cardinality: 1..1

Type: Reference(Observation)

Summary: true

Mappings: workflow=Event.reason

DeviceAlert.derivedFrom.component

The Observation.component having a value causing the alert condition

Definition: If applicable, the code of the component (of the Observation identified in derivedFrom.observation) having a value causing the alert condition. This might be used when the alert is associated with a specific component of an Observation, rather than the overall Observation; for example, a low diastolic blood pressure. Since the component is identified by matching Observation.component.code, if more than one component have the same code, the specific component is ambiguous. Repetitions of this element indicate additional components contributing to the alert condition.

Cardinality: 0..1

Type: Coding

Binding: example:observation-codes

Summary: false

DeviceAlert.derivedFrom.limit

The boundaries beyond which a value was detected to cause the alert condition

Definition: The limits beyond which a value was detected to cause the alert condition. The actual value is the Observation.value[x] referenced by derivedFrom.observation or, if specified, the Observation.component.value[x] of the component (with Observation.component.code matching derivedFrom.component) of the reference Observation.

Cardinality: 0..1

Type: Range

Summary: false

Mappings: DIM=Limit-Specification; BICEPS=LimitAlertConditionState/Limits

DeviceAlert.label

Text to be displayed for the alert condition

Definition: The label might combine information from the alert code, priority, the measurement type, measurement value, body sites and other sources, e.g., “HR > 180”.

Cardinality: 0..1

Type: string

Summary: false

Mappings: DIM=AlertCondition/Label-String; BICEPS=AlertConditionDescriptor/TypeConceptDescription

DeviceAlert.signal

Annunciation or notification of the alert condition

Cardinality: 0..*

Type: BackboneElement

Summary: false

Mappings: DIM=AlertCondition/AlertFlags; AlertCondition/AlertControls; BICEPS=AlertSignalState

DeviceAlert.signal.activationState

on | off | paused

Definition: Paused indicates that annunciation has temporarily been disabled ("snooze").

Cardinality: 1..1

Type: CodeableConcept

Binding: extensible:devicealert-activationState

Summary: true

Mappings: DIM=AlertCondition/AlertState; BICEPS=AlertSignalState/ActivationState

DeviceAlert.signal.presence

on | latched | off | ack

Definition: Indicates whether the signal is currently being annunciated. An on signal is currently being annunciated; a latched signal is currently being being annunciated although the alert condition has ended; an off signal is not currently being annunciated; and an acknowledged signal is not currently being annunciated because the user has acknowledged the signal.

Cardinality: 0..1

Type: CodeableConcept

Binding: extensible:devicealert-presence

Summary: false

Mappings: BICEPS=AlertSignalState/Presence

DeviceAlert.signal.annunciator

Where the signal is being annunciated

Definition: Signalling by the source device is local; signalling elsewhere is considered remote. A reference to the "top level" signalling device could also be present.

Cardinality: 0..1

Type: CodeableReference

Binding: required:devicealert-annunciation

Summary: false

Mappings: DIM=AlertCondition/AlertFlags; BICEPS=AlertSignalDescriptor/Manifestation

DeviceAlert.signal.manifestation

How the signal is being annunciated

Cardinality: 0..1

Type: CodeableConcept

Binding: extensible:devicealert-manifestation

Summary: false

Mappings: DIM=AlertCondition/AlertFlags; BICEPS=AlertSignalState/Location

DeviceAlert.signal.type

Characteristics of the signal manifestation

Definition: Details of the signal manifestation, such as a 1 meter visual indicator or a 4 meter visual indicator.

Cardinality: 0..*

Type: CodeableConcept

Binding: example:devicealert-signalType

Summary: false

Mappings: BICEPS=AlertSystemDescriptor/AlertSignal/Type

DeviceAlert.signal.indication

When the signal was being annunciated

Definition: The period during which the signal was being annunciated. If there is no indicated period end, the annunciation is on-going.

Comments: The indication period start when the signal presence is first on (or latched) and ends when the signal becomes off or acknowledged.

Cardinality: 0..1

Type: Period

Summary: false

Mappings: BICEPS=Start: AlertConditionState/DeterminationTime + AlertConditionState/ActualConditionGenerationDelay + AlertSignalState/ActualSignalGenerationDelay End: Change of AlertConditionState/DeterminationTime