type: resource-definitionsresource: PlanDefinition

PlanDefinition Definitions

PlanDefinition

The definition of a plan for a series of actions, independent of any specific patient or context

Definition: This resource allows for the definition of various types of plans as a sharable, consumable, and executable artifact. The resource is general enough to support the description of a broad range of clinical and non-clinical artifacts such as clinical decision support rules, order sets, protocols, and drug quality specifications.

Cardinality: 0..*

Constraints: cnl-0 | warning | Name should be usable as an identifier for the module by machine processing applications such as code generation | name.exists() implies name.matches('^A-Z{1,254}$'); pld-3 | warning | goalid should reference the id of a goal definition | %context.repeat(action).where((goalId in %context.goal.id).not()).exists().not(); pld-4 | warning | targetId should reference the id of an action | %context.repeat(action).relatedAction.where((targetId in %context.repeat(action).id).not()).exists().not()

Mappings: workflow=Definition; rim=Act[classCode=GROUPER;moodCode=DEFN]; w5=clinical.general

PlanDefinition.url

Canonical identifier for this plan definition, represented as a URI (globally unique)

Definition: An absolute URI that is used to identify this plan definition when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which an authoritative instance of this plan definition is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the plan definition is stored on different servers.

Comments: Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version.

The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in Technical and Business Versions.

In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the meta.source element to indicate where the current master source of the resource can be found.

Requirements: Allows the plan definition to be referenced by a single globally unique identifier.

Cardinality: 0..1

Type: uri

Summary: true

Mappings: workflow=Definition.url; w5=FiveWs.identifier; rim=.identifier[scope=BUSN;reliability=ISS]

PlanDefinition.identifier

Additional identifier for the plan definition

Definition: A formal identifier that is used to identify this plan definition when it is represented in other formats, or referenced in a specification, model, design or an instance.

Requirements: Allows externally provided and/or usable business identifiers to be easily associated with the module.

Cardinality: 0..*

Type: Identifier

Summary: true

Mappings: workflow=Definition.identifier; w5=FiveWs.identifier; rim=.identifier; objimpl=no-gen-base

PlanDefinition.version

Business version of the plan definition

Definition: The identifier that is used to identify this version of the plan definition when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the plan definition author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. To provide a version consistent with the Decision Support Service specification, use the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer to the Decision Support Service specification. Note that a version is required for non-experimental active artifacts.

Comments: There may be different plan definition instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the plan definition with the format [url]|[version]. The version SHOULD NOT contain a '#' - see Business Version.

Cardinality: 0..1

Type: string

Summary: true

Mappings: workflow=Definition.version; w5=FiveWs.version; rim=N/A (to add?); objimpl=no-gen-base

PlanDefinition.versionAlgorithm[x]

How to compare versions

Definition: Indicates the mechanism used to compare versions to determine which is more current.

Comments: If set as a string, this is a FHIRPath expression that has two additional context variables passed in - %version1 and %version2 and will return a negative number if version1 is newer, a positive number if version2 and a 0 if the version ordering can't be successfully be determined.

Cardinality: 0..1

Type: string, Coding

Binding: extensible:version-algorithm

Summary: true

Mappings: workflow=Definition.versionAlgorithm; w5=FiveWs.version; rim=N/A (to add?); objimpl=no-gen-base

PlanDefinition.name

Name for this plan definition (computer friendly)

Definition: A natural language name identifying the plan definition. This name should be usable as an identifier for the module by machine processing applications such as code generation.

Comments: The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

Requirements: Support human navigation and code generation.

Conditions: cnl-0

Cardinality: 0..1

Type: string

Summary: true

Mappings: workflow=Definition.name; rim=N/A (to add?)

PlanDefinition.title

Name for this plan definition (human friendly)

Definition: A short, descriptive, user-friendly title for the plan definition.

Comments: This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

Cardinality: 0..1

Type: string

Summary: true

Mappings: workflow=Definition.title; rim=.title

PlanDefinition.subtitle

Subordinate title of the plan definition

Definition: An explanatory or alternate title for the plan definition giving additional information about its content.

Cardinality: 0..1

Type: string

Mappings: rim=N/A

PlanDefinition.type

order-set | protocol | eca-rule | workflow-definition | etc.

Definition: A high-level category for the plan definition that distinguishes the kinds of systems that would be interested in the plan definition.

Cardinality: 0..1

Type: CodeableConcept

Binding: extensible:plan-definition-type

Summary: true

Mappings: rim=N/A (to add?)

PlanDefinition.status

draft | active | retired | unknown

Definition: The status of this plan definition. Enables tracking the life-cycle of the content.

Comments: Allows filtering of plan definitions that are appropriate for use versus not.

See guidance around (not) making local changes to elements here.

Cardinality: 1..1

Type: code

Binding: required:publication-status

Summary: true

Is Modifier: true (Reason: This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration)

Mappings: workflow=Definition.status {different ValueSet}; w5=FiveWs.status; rim=.status

PlanDefinition.experimental

For testing only - never for real usage

Definition: A Boolean value to indicate that this plan definition is authored for testing purposes (or education/evaluation/marketing) and no version of this resource will ever be intended for genuine usage.

Comments: Allows filtering of plan definitions that are appropriate for use versus not.. Experimental resources might include example instances in implementation guides, instances created solely for testing purposes, etc

Requirements: Enables experimental content to be developed following the same lifecycle that would be used for a production-level plan definition.

Meaning if Missing: If absent, this resource is treated as though it is not experimental.

Cardinality: 0..1

Type: boolean

Summary: true

Mappings: workflow=Definition.experimental; w5=FiveWs.class; rim=N/A (to add?)

PlanDefinition.subject[x]

Type of individual the plan definition is focused on

Definition: A code, group definition, or canonical reference that describes or identifies the intended subject of the plan definition. Canonical references are allowed to support the definition of protocols for drug and substance quality specifications, and is allowed to reference a MedicinalProductDefinition, SubstanceDefinition, AdministrableProductDefinition, ManufacturedItemDefinition, or PackagedProductDefinition resource.

Comments: Note that the choice of canonical for the subject element was introduced in R4B to support pharmaceutical quality use cases. To ensure as much backwards-compatibility as possible, it is recommended to only use the new canonical type with these use cases.

Meaning if Missing: Patient

Cardinality: 0..1

Type: CodeableConcept, Reference(Group, MedicinalProductDefinition, SubstanceDefinition, AdministrableProductDefinition, ManufacturedItemDefinition, PackagedProductDefinition), canonical

Binding: extensible:participant-resource-types

Mappings: workflow=Definition.subject; rim=N/A

PlanDefinition.date

Date last changed

Definition: The date (and optionally time) when the plan definition was last significantly changed. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the plan definition changes.

Comments: The date is often not tracked until the resource is published, but may be present on draft content. Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the plan definition. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

See guidance around (not) making local changes to elements here.

Aliases: Revision Date

Cardinality: 0..1

Type: dateTime

Summary: true

Mappings: workflow=Definition.date; w5=FiveWs.recorded; rim=.participation[typeCode=AUT].time

PlanDefinition.publisher

Name of the publisher/steward (organization or individual)

Definition: The name of the organization or individual responsible for the release and ongoing maintenance of the plan definition.

Comments: Usually an organization but may be an individual. The publisher (or steward) of the plan definition is the organization or individual primarily responsible for the maintenance and upkeep of the plan definition. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the plan definition. This item SHOULD be populated unless the information is available from context.

Requirements: Helps establish the "authority/credibility" of the plan definition. May also allow for contact.

Cardinality: 0..1

Type: string

Summary: true

Mappings: workflow=Definition.publisher; w5=FiveWs.witness; rim=.participation[typeCode=AUT].role

PlanDefinition.contact

Contact details for the publisher

Definition: Contact details to assist a user in finding and communicating with the publisher.

Comments: May be a web site, an email address, a telephone number, etc.

See guidance around (not) making local changes to elements here.

Cardinality: 0..*

Type: ContactDetail

Summary: true

Mappings: workflow=Definition.contact; rim=.participation[typeCode=CALLBCK].role

PlanDefinition.description

Natural language description of the plan definition

Definition: A free text natural language description of the plan definition from a consumer's perspective.

Comments: This description can be used to capture details such as comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the plan definition as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the plan definition is presumed to be the predominant language in the place the plan definition was created).

Cardinality: 0..1

Type: markdown

Summary: true

Mappings: workflow=Definition.description; rim=.text

PlanDefinition.useContext

The context that the content is intended to support

Definition: The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate plan definition instances.

Comments: When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

Requirements: Assist in searching for appropriate content.

Cardinality: 0..*

Type: UsageContext

Summary: true

Mappings: workflow=Definition.useContext; rim=N/A (to add?)

PlanDefinition.jurisdiction

Jurisdiction of the authority that maintains the plan definition (if applicable)

Definition: A legal or geographic region in which the authority that maintains the resource is operating. In general, the jurisdiction is also found in the useContext. The useContext may reference additional jurisdictions because the defining jurisdiction does not necessarily limit the jurisdictions of use.

Comments: It may be possible for the plan definition to be used in jurisdictions other than those for which it was originally designed or intended.

DEPRECATION NOTE: For consistency, implementations are encouraged to migrate to using the new 'jurisdiction' code in the useContext element. (I.e. useContext.code indicating http://terminology.hl7.org/CodeSystem/usage-context-type#jurisdiction and useContext.valueCodeableConcept indicating the jurisdiction.)

Cardinality: 0..*

Type: CodeableConcept

Binding: extensible:jurisdiction

Summary: true

Mappings: workflow=Definition.jurisdiction; rim=N/A (to add?)

PlanDefinition.purpose

Why this plan definition is defined

Definition: Explanation of why this plan definition is needed and why it has been designed as it has.

Comments: This element does not describe the usage of the plan definition. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this plan definition.

Cardinality: 0..1

Type: markdown

Mappings: workflow=Definition.purpose; w5=FiveWs.why[x]; rim=.reasonCode.text; objimpl=no-gen-base

PlanDefinition.usage

Describes the clinical usage of the plan

Definition: A detailed description of how the plan definition is used from a clinical perspective.

Cardinality: 0..1

Type: markdown

Mappings: rim=N/A (to add?)

PlanDefinition.copyright

Notice about intellectual property ownership, can include restrictions on use

Definition: A copyright statement relating to the plan definition and/or its contents. Copyright statements are notices of intellectual property ownership and can include restrictions on the use and publishing of the plan definition.

Comments: The short copyright declaration (e.g. (c) '2015+ xyz organization') should be sent in the copyrightLabel element without the copyright prefix (i.e., do not include '(c)' or the symbol).

Requirements: Consumers must be able to determine any legal restrictions on the use of the plan definition and/or its content.

Aliases: License, Restrictions

Cardinality: 0..1

Type: markdown

Mappings: workflow=Definition.copyright; rim=N/A (to add?); objimpl=no-gen-base

PlanDefinition.copyrightLabel

Definition: A short string (<50 characters), suitable for inclusion in a page footer that identifies the copyright holder, effective period, and optionally whether rights are restricted. (e.g. 'All rights reserved', 'Some rights reserved').

Comments: The copyright symbol and the '(c)' textual representation SHOULD NOT be included in this string. It will be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.

Requirements: Defines the content expected to be rendered in all representations of the artifact.

Cardinality: 0..1

Type: string

Mappings: workflow=Definition.copyrightLabel; rim=N/A (to add?); objimpl=no-gen-base

PlanDefinition.approvalDate

When the plan definition was approved by publisher

Definition: The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.

Comments: The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.

See guidance around (not) making local changes to elements here.

Cardinality: 0..1

Type: date

Mappings: workflow=Definition.approvalDate; rim=.outboundRelationship[typeCode="SUBJ"].act[classCode=CACT;moodCode=EVN;code="approval"].effectiveTime; objimpl=no-gen-base

PlanDefinition.lastReviewDate

When the plan definition was last reviewed by the publisher

Definition: The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.

Comments: If specified, this date follows the original approval date.

See guidance around (not) making local changes to elements here.

Requirements: Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant.

Cardinality: 0..1

Type: date

Mappings: workflow=Definition.lastReviewDate; rim=.outboundRelationship[typeCode="SUBJ"; subsetCode="RECENT"].act[classCode=CACT;moodCode=EVN;code="review"].effectiveTime; objimpl=no-gen-base

PlanDefinition.effectivePeriod

When the plan definition is expected to be used

Definition: The period during which the plan definition content was or is planned to be in active use.

Comments: The effective period for a plan definition determines when the content is applicable for usage and is independent of publication and review dates. For example, a plan definition intended to be used for the year 2016 might be published in 2015.

See guidance around (not) making local changes to elements here.

Requirements: Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of the plan definition are or are expected to be used instead.

Cardinality: 0..1

Type: Period

Summary: true

Mappings: workflow=Definition.effectivePeriod; rim=N/A (to add?); objimpl=no-gen-base

PlanDefinition.topic

E.g. Education, Treatment, Assessment

Definition: Descriptive topics related to the content of the plan definition. Topics provide a high-level categorization of the definition that can be useful for filtering and searching.

Comments: DEPRECATION NOTE: For consistency, implementations are encouraged to migrate to using the new 'topic' code in the useContext element. (I.e. useContext.code indicating http://terminology.hl7.org/CodeSystem/usage-context-type#topic and useContext.valueCodeableConcept indicating the topic)

Requirements: Repositories must be able to determine how to categorize the plan definition so that it can be found by topical searches.

Cardinality: 0..*

Type: CodeableConcept

Binding: example:definition-topic

Mappings: workflow=Definition.subject[x]; rim=N/A (to add?)

PlanDefinition.author

Who authored the content

Definition: An individiual or organization primarily involved in the creation and maintenance of the content.

Cardinality: 0..*

Type: ContactDetail

Mappings: rim=.participation[typeCode=AUT]

PlanDefinition.editor

Who edited the content

Definition: An individual or organization primarily responsible for internal coherence of the content.

Cardinality: 0..*

Type: ContactDetail

Mappings: rim=.participation[typeCode=AUT]

PlanDefinition.reviewer

Who reviewed the content

Definition: An individual or organization asserted by the publisher to be primarily responsible for review of some aspect of the content.

Comments: See guidance around (not) making local changes to elements here.

Cardinality: 0..*

Type: ContactDetail

Mappings: rim=.participation[typeCode=VRF] {not clear whether VRF best corresponds to reviewer or endorser}

PlanDefinition.endorser

Who endorsed the content

Definition: An individual or organization asserted by the publisher to be responsible for officially endorsing the content for use in some setting.

Comments: See guidance around (not) making local changes to elements here.

Cardinality: 0..*

Type: ContactDetail

Mappings: rim=.participation[typeCode=VRF] {not clear whether VRF best corresponds to reviewer or endorser}

PlanDefinition.relatedArtifact

Additional documentation, citations

Definition: Related artifacts such as additional documentation, justification, or bibliographic references.

Comments: Each related artifact is either an attachment, or a reference to another resource, but not both. In addition, the successor or predecessor of a PlanDefinition SHOULD be a PlanDefinition, dependencies of a PlanDefinition SHOULD reference a resource, and a PlanDefinition SHOULD NOT have components.

Requirements: Plan definitions must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content.

Cardinality: 0..*

Type: RelatedArtifact

Mappings: rim=.outboundRelationship[typeCode=DOC,RSON,PREV, DRIV, USE, COMP] {successor would be PREV w/ inversionInd=true; No support for citation}

PlanDefinition.library

Logic used by the plan definition

Definition: A reference to a Library resource containing any formal logic used by the plan definition.

Cardinality: 0..*

Type: canonical

Mappings: rim=N/A (to add?)

PlanDefinition.goal

What the plan is trying to accomplish

Definition: A goal describes an expected outcome that activities within the plan are intended to achieve. For example, weight loss, restoring an activity of daily living, obtaining herd immunity via immunization, meeting a process improvement objective, meeting the acceptance criteria for a test as specified by a quality specification, etc.

Requirements: Goal information needs to be captured for order sets, protocols, and care plan definitions to better describe the objectives of the protocol activities and to guide the creation of specific goals within the derived care plans and orders.

Conditions: pld-3

Cardinality: 0..*

Type: BackboneElement

Mappings: rim=N/A (to add?)

PlanDefinition.goal.category

E.g. Treatment, dietary, behavioral

Definition: Indicates a category the goal falls within.

Cardinality: 0..1

Type: CodeableConcept

Binding: example:goal-category

Mappings: rim=N/A (to add?)

PlanDefinition.goal.description

Code or text describing the goal

Definition: Human-readable and/or coded description of a specific desired objective of care, such as "control blood pressure" or "negotiate an obstacle course" or "dance with child at wedding".

Comments: If no code is available, use CodeableConcept.text.

Cardinality: 1..1

Type: CodeableConcept

Binding: example:clinical-findings

Mappings: rim=N/A (to add?)

PlanDefinition.goal.priority

high-priority | medium-priority | low-priority

Definition: Identifies the expected level of importance associated with reaching/sustaining the defined goal.

Cardinality: 0..1

Type: CodeableConcept

Binding: preferred:goal-priority

Mappings: rim=N/A (to add?)

PlanDefinition.goal.start

When goal pursuit begins

Definition: The event after which the goal should begin being pursued.

Cardinality: 0..1

Type: CodeableConcept

Binding: example:goal-start-event

Mappings: rim=N/A (to add?)

PlanDefinition.goal.addresses

What does the goal address

Definition: Identifies problems, conditions, issues, or concerns the goal is intended to address.

Cardinality: 0..*

Type: CodeableConcept

Binding: example:condition-code

Mappings: rim=N/A (to add?)

PlanDefinition.goal.documentation

Supporting documentation for the goal

Definition: Didactic or other informational resources associated with the goal that provide further supporting information about the goal. Information resources can include inline text commentary and links to web resources.

Cardinality: 0..*

Type: RelatedArtifact

Mappings: rim=N/A (to add?)

PlanDefinition.goal.target

Target outcome for the goal

Definition: Indicates what should be done and within what timeframe.

Cardinality: 0..*

Type: BackboneElement

Mappings: rim=N/A (to add?)

PlanDefinition.goal.target.measure

The parameter whose value is to be tracked

Definition: The parameter whose value is to be tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.

Cardinality: 0..1

Type: CodeableConcept

Binding: example:observation-codes

Mappings: rim=N/A (to add?)

PlanDefinition.goal.target.detail[x]

The target value to be achieved

Definition: The target value of the measure to be achieved to signify fulfillment of the goal, e.g. 150 pounds or 7.0%, or in the case of pharmaceutical quality - NMT 0.6%, Clear solution, etc. Either the high or low or both values of the range can be specified. When a low value is missing, it indicates that the goal is achieved at any value at or below the high value. Similarly, if the high value is missing, it indicates that the goal is achieved at any value at or above the low value.

Comments: A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the goal.target.measure defines a coded value.

Cardinality: 0..1

Type: Quantity, Range, CodeableConcept, string, boolean, integer, Ratio

Mappings: rim=N/A (to add?)

PlanDefinition.goal.target.due

Reach goal within

Definition: Indicates the timeframe after the start of the goal in which the goal should be met.

Cardinality: 0..1

Type: Duration

Mappings: rim=N/A (to add?)

PlanDefinition.actor

Actors within the plan

Definition: Actors represent the individuals or groups involved in the execution of the defined set of activities.

Cardinality: 0..*

Type: BackboneElement

Mappings: rim=.participation[typeCode=PFM]

PlanDefinition.actor.title

User-visible title

Definition: A descriptive label for the actor.

Cardinality: 0..1

Type: string

Mappings: rim=N/A (to add?)

PlanDefinition.actor.description

Describes the actor

Definition: A description of how the actor fits into the overall actions of the plan definition.

Cardinality: 0..1

Type: markdown

Mappings: rim=N/A (to add?)

PlanDefinition.actor.option

Who or what can be this actor

Definition: The characteristics of the candidates that could serve as the actor.

Cardinality: 1..*

Type: BackboneElement

Mappings: rim=N/A (to add?)

PlanDefinition.actor.option.type

Definition: The type of participant in the action.

Cardinality: 0..1

Type: code

Binding: required:action-participant-type

Mappings: rim=.role.classCode

PlanDefinition.actor.option.typeCanonical

Who or what can participate

Definition: The type of participant in the action.

Cardinality: 0..1

Type: canonical

Mappings: rim=.role.classCode

PlanDefinition.actor.option.typeReference

Who or what can participate

Definition: The type of participant in the action.

Comments: When this element is a reference, it SHOULD be a reference to a definitional resource (for example, a location type, rather than a specific location). Note that specimen as a participant in cell-line research is acceptable, but specimen in clinical research would typically be represented as the focus rather the subject.

Cardinality: 0..1

Type: Reference(BiologicallyDerivedProduct, CareTeam, Device, Endpoint, HealthcareService, Location, Medication, MedicinalProductDefinition, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson, Specimen, Substance, SubstanceDefinition)

Mappings: rim=.role.classCode

PlanDefinition.actor.option.role

E.g. Nurse, Surgeon, Parent

Definition: The role the participant should play in performing the described action.

Cardinality: 0..1

Type: CodeableConcept

Binding: example:action-participant-role

Mappings: rim=N/A (to add?)

PlanDefinition.action

Action defined by the plan

Definition: An action or group of actions to be taken as part of the plan. For example, in clinical care, an action would be to prescribe a particular indicated medication, or perform a particular test as appropriate. In pharmaceutical quality, an action would be the test that needs to be performed on a drug product as defined in the quality specification or the steps that are planned in a manufacturing process of a drug product or a drug substance.

Comments: Note that there is overlap between many of the elements defined here and the ActivityDefinition resource. When an ActivityDefinition is referenced (using the definition element), the overlapping elements in the plan override the content of the referenced ActivityDefinition unless otherwise documented in the specific elements. See the PlanDefinition resource for more detailed information.

Conditions: pld-3, pld-4

Cardinality: 0..*

Type: BackboneElement

Mappings: workflow={Is a contained Definition}; rim=Act[classCode=ACT; moodCode=DEFN]

PlanDefinition.action.linkId

Unique id for the action in the PlanDefinition

Definition: An identifier that is unique within the PlanDefinition to allow linkage within the realized CarePlan and/or RequestOrchestration.

Cardinality: 0..1

Type: string

Mappings: rim=N/A (to add?)

PlanDefinition.action.prefix

User-visible prefix for the action (e.g. 1. or A.)

Definition: A user-visible prefix for the action. For example a section or item numbering such as 1. or A.

Cardinality: 0..1

Type: string

Mappings: rim=N/A (to add?)

PlanDefinition.action.title

User-visible title

Definition: The textual description of the action displayed to a user. For example, when the action is a test to be performed, the title would be the title of the test such as Assay by HPLC.

Cardinality: 0..1

Type: string

Mappings: workflow=Definition.title; rim=.title

PlanDefinition.action.description

Brief description of the action

Definition: A brief description of the action used to provide a summary to display to the user.

Cardinality: 0..1

Type: markdown

Mappings: workflow=Definition.description; rim=.text

PlanDefinition.action.textEquivalent

Static text equivalent of the action, used if the dynamic aspects cannot be interpreted by the receiving system

Definition: A text equivalent of the action to be performed. This provides a human-interpretable description of the action when the definition is consumed by a system that might not be capable of interpreting it dynamically.

Cardinality: 0..1

Type: markdown

Mappings: workflow=Definition.description; rim=.text

PlanDefinition.action.priority

routine | urgent | asap | stat

Definition: Indicates how quickly the action should be addressed with respect to other actions.

Cardinality: 0..1

Type: code

Binding: required:request-priority

Mappings: rim=.priority

PlanDefinition.action.code

Code representing the meaning of the action or sub-actions

Definition: A code that provides a meaning, grouping, or classification for the action or action group. For example, a section may have a LOINC code for the section of a documentation template. In pharmaceutical quality, an action (Test) such as pH could be classified as a physical property.

Cardinality: 0..1

Type: CodeableConcept

Binding: example:action-code

Mappings: rim=.classCode

PlanDefinition.action.reason

Why the action should be performed

Definition: A description of why this action is necessary or appropriate.

Comments: This is different than the clinical evidence documentation, it's an actual business description of the reason for performing the action.

Cardinality: 0..*

Type: CodeableConcept

Binding: example:action-reason-code

Mappings: rim=.reasonCode

PlanDefinition.action.documentation

Supporting documentation for the intended performer of the action

Definition: Didactic or other informational resources associated with the action that can be provided to the CDS recipient. Information resources can include inline text commentary and links to web resources.

Cardinality: 0..*

Type: RelatedArtifact

Mappings: rim=N/A (to add?)

PlanDefinition.action.goalId

What goals this action supports

Definition: Identifies goals that this action supports. The reference must be to a goal element defined within this plan definition. In pharmaceutical quality, a goal represents acceptance criteria (Goal) for a given action (Test), so the goalId would be the unique id of a defined goal element establishing the acceptance criteria for the action.

Conditions: pld-3

Cardinality: 0..*

Type: string

Mappings: rim=N/A (to add?)

PlanDefinition.action.subject[x]

Type of individual the action is focused on

Definition: A code, group definition, or canonical reference that describes the intended subject of the action and its children, if any. Canonical references are allowed to support the definition of protocols for drug and substance quality specifications, and is allowed to reference a MedicinalProductDefinition, SubstanceDefinition, AdministrableProductDefinition, ManufacturedItemDefinition, or PackagedProductDefinition resource.

Comments: The subject of an action overrides the subject at a parent action or on the root of the PlanDefinition if specified.

In addition, because the subject needs to be resolved during realization, use of subjects in actions (or in the ActivityDefinition referenced by the action) resolves based on the set of subjects supplied in context and by type (i.e. the patient subject would resolve to a resource of type Patient).

Requirements: Multiple steps in a protocol often have different groups of steps that are focused on testing different things. The subject of an action specifies the focus of the action and any child actions.

Meaning if Missing: Patient

Cardinality: 0..1

Type: CodeableConcept, Reference(Group), canonical

Binding: extensible:participant-resource-types

Mappings: workflow=Definition.subject; rim=N/A (to add?)

PlanDefinition.action.trigger

When the action should be triggered

Definition: A description of when the action should be triggered. When multiple triggers are specified on an action, any triggering event invokes the action.

Cardinality: 0..*

Type: TriggerDefinition

Mappings: rim=N/A (to add?)

PlanDefinition.action.condition

Whether or not the action is applicable

Definition: An expression that describes applicability criteria or start/stop conditions for the action.

Comments: If no applicability conditions are present, the action is considered applicable (i.e. it should be performed). When multiple conditions of the same kind are present, the effects are combined using AND semantics, so the overall condition is true only if all the conditions are true. Conditions of different kinds are always considered separately (e.g. applicability and start criteria are never considered together)

Cardinality: 0..*

Type: BackboneElement

Mappings: rim=N/A (to add?)

PlanDefinition.action.condition.kind

applicability | start | stop

Definition: The kind of condition.

Comments: Applicability criteria are used to determine immediate applicability when a plan definition is applied to a given context. Start and stop criteria are carried through application and used to describe enter/exit criteria for an action.

Cardinality: 1..1

Type: code

Binding: required:action-condition-kind

Mappings: rim=N/A (to add?)

PlanDefinition.action.condition.expression

Boolean-valued expression

Definition: An expression that returns true or false, indicating whether the condition is satisfied.

Comments: The expression may be inlined or may be a reference to a named expression within a logic library referenced by the library element.

Cardinality: 0..1

Type: Expression

Mappings: rim=N/A (to add?)

PlanDefinition.action.input

Input data requirements

Definition: Defines input data requirements for the action.

Cardinality: 0..*

Type: BackboneElement

Constraints: pld-0 | error | Input data elements must have a requirement or a relatedData, but not both | requirement.exists() xor relatedData.exists()

Mappings: rim=N/A (to add?)

PlanDefinition.action.input.title

User-visible title

Definition: A human-readable label for the data requirement used to label data flows in BPMN or similar diagrams. Also provides a human readable label when rendering the data requirement that conveys its purpose to human readers.

Cardinality: 0..1

Type: string

Mappings: rim=N/A (to add?)

PlanDefinition.action.input.requirement

What data is provided

Definition: Defines the data that is to be provided as input to the action.

Conditions: pld-0

Cardinality: 0..1

Type: DataRequirement

Mappings: rim=N/A (to add?)

PlanDefinition.action.input.relatedData

What data is provided

Definition: Points to an existing input or output element that provides data to this input.

Comments: The relatedData element allows indicating that an input to a parent action is an input to specific child actions. It also allows the output of one action to be identified as the input to a different action

Conditions: pld-0

Cardinality: 0..1

Type: string

Mappings: rim=N/A (to add?)

PlanDefinition.action.output

Output data definition

Definition: Defines the outputs of the action, if any.

Cardinality: 0..*

Type: BackboneElement

Constraints: pld-1 | error | Output data element must have a requirement or a relatedData, but not both | requirement.exists() xor relatedData.exists()

Mappings: rim=N/A (to add?)

PlanDefinition.action.output.title

User-visible title

Cardinality: 0..1

Type: string

Mappings: rim=N/A (to add?)

PlanDefinition.action.output.requirement

What data is provided

Definition: Defines the data that results as output from the action.

Conditions: pld-1

Cardinality: 0..1

Type: DataRequirement

Mappings: rim=N/A (to add?)

PlanDefinition.action.output.relatedData

What data is provided

Definition: Points to an existing input or output element that is results as output from the action.

Comments: The relatedData element allows indicating that the output of child action is also the output of a parent action. It also allows the input of one action to be identified as the output of a different action

Conditions: pld-1

Cardinality: 0..1

Type: string

Mappings: rim=N/A (to add?)

PlanDefinition.action.relatedAction

Relationship to another action

Definition: A relationship to another action such as "before" or "30-60 minutes after start of".

Comments: When an action depends on multiple actions, the meaning is that all actions are dependencies, rather than that any of the actions are a dependency.

Conditions: pld-4

Cardinality: 0..*

Type: BackboneElement

Mappings: rim=N/A (to add?)

PlanDefinition.action.relatedAction.targetId

What action is this related to

Definition: The element id of the target related action.

Conditions: pld-4

Cardinality: 1..1

Type: string

Mappings: rim=N/A (to add?)

PlanDefinition.action.relatedAction.relationship

Definition: The relationship of the start of this action to the related action.

Cardinality: 1..1

Type: code

Binding: required:action-relationship-type

Mappings: rim=N/A (to add?)

PlanDefinition.action.relatedAction.endRelationship

Definition: The relationship of the end of this action to the related action.

Cardinality: 0..1

Type: code

Binding: required:action-relationship-type

Mappings: rim=N/A (to add?)

PlanDefinition.action.relatedAction.offset[x]

Time offset for the relationship

Definition: A duration or range of durations to apply to the relationship. For example, 30-60 minutes before.

Cardinality: 0..1

Type: Duration, Range

Mappings: rim=N/A (to add?)

PlanDefinition.action.timing[x]

When the action should take place

Definition: An optional value describing when the action should be performed.

Comments: The intent of the timing element is to provide timing when the action should be performed. As a definitional resource, this timing is interpreted as part of an apply operation so that the timing of the result actions in a CarePlan or RequestOrchestration, for example, would be specified by evaluating the timing definition in the context of the apply and setting the resulting timing on the appropriate elements of the target resource. If the timing is an Age, the activity is expected to be performed when the subject is the given Age. When the timing is a Duration, the activity is expected to be performed within the specified duration from the apply. When the timing is a Range, it may be a range of Ages or Durations, providing a range for the expected timing of the resulting activity. When the timing is a Timing, it is establishing a schedule for the timing of the resulting activity.

Requirements: Allows prompting for activities and detection of missed planned activities.

Cardinality: 0..1

Type: Age, Duration, Range, Timing, RelativeTime

Mappings: rim=.effectiveTime

PlanDefinition.asNeeded[x]

Preconditions for service

Definition: If a CodeableConcept is present, it indicates the pre-condition for performing the service. For example "pain", "on flare-up", etc.

Cardinality: 0..1

Type: boolean, CodeableConcept

Binding: example:medication-as-needed-reason

Summary: true

Mappings: rim=boolean: precondition.negationInd (inversed - so negationInd = true means asNeeded=false CodeableConcept: precondition.observationEventCriterion[code="Assertion"].value

PlanDefinition.action.location

Where it should happen

Definition: Identifies the facility where the action will occur; e.g. home, hospital, specific clinic, etc.

Comments: May reference a specific clinical location or may just identify a type of location.

Requirements: Helps in planning of activity.

Aliases: facility

Cardinality: 0..1

Type: CodeableReference

Mappings: rim=.participation[typeCode=LOC].role

PlanDefinition.action.participant

Who should participate in the action

Definition: Indicates who should participate in performing the action described.

Cardinality: 0..*

Type: BackboneElement

Mappings: rim=.participation[typeCode=PFM]

PlanDefinition.action.participant.actorId

What actor

Definition: A reference to the id element of the actor who will participate in this action.

Cardinality: 0..1

Type: string

Mappings: rim=N/A (to add?)

PlanDefinition.action.participant.type

Definition: The type of participant in the action.

Cardinality: 0..1

Type: code

Binding: required:action-participant-type

Mappings: rim=.role.classCode

PlanDefinition.action.participant.typeCanonical

Who or what can participate

Definition: The type of participant in the action.

Cardinality: 0..1

Type: canonical

Mappings: rim=.role.classCode

PlanDefinition.action.participant.typeReference

Who or what can participate

Definition: The type of participant in the action.

Cardinality: 0..1

Mappings: rim=.role.classCode

PlanDefinition.action.participant.role

E.g. Nurse, Surgeon, Parent

Definition: The role the participant should play in performing the described action.

Cardinality: 0..1

Type: CodeableConcept

Binding: example:action-participant-role

Mappings: rim=.role.code

PlanDefinition.action.participant.function

E.g. Author, Reviewer, Witness, etc

Definition: Indicates how the actor will be involved in the action - author, reviewer, witness, etc.

Cardinality: 0..1

Type: CodeableConcept

Binding: example:action-participant-function

Mappings: rim=.role.code

PlanDefinition.action.type

create | update | remove | fire-event | etc.

Definition: The type of action to perform (create, update, remove).

Cardinality: 0..1

Type: CodeableConcept

Binding: extensible:action-type

Mappings: rim=.moodCode { Maybe? this is effectively Create, Update, or Delete }

PlanDefinition.action.applicabilityBehavior

all | any

Definition: All - meaning the applicability of each child action is evaluated independently; if a child action is applicable according to the applicability criteria, it is applied. Any - meaning that each child action is evaluated in order, and the first action that returns an applicability of true will be applied, and processing of the parent action will stop. If not specified, the default behavior of All is used.

Meaning if Missing: If no applicability behavior is specified but the action has children, the default applicability criteria of All is assumed, meaning that each child action is evaluated independently.

Cardinality: 0..1

Type: code

Binding: required:action-applicability-behavior

Mappings: rim=N/A

PlanDefinition.action.groupingBehavior

visual-group | logical-group | sentence-group

Definition: Defines the grouping behavior for the action and its children.

Meaning if Missing: If no grouping behavior is specified but the action has children (i.e. is a group), the grouping behavior is assumed to be logical-group.

Cardinality: 0..1

Type: code

Binding: required:action-grouping-behavior

Mappings: rim=N/A

PlanDefinition.action.selectionBehavior

Definition: Defines the selection behavior for the action and its children.

Meaning if Missing: If no selection behavior is specified but the action has children (i.e. is a group), the selection behavior is assumed to be all.

Cardinality: 0..1

Type: code

Binding: required:action-selection-behavior

Mappings: rim=N/A

PlanDefinition.action.requiredBehavior

must | could | must-unless-documented

Definition: Defines the required behavior for the action.

Meaning if Missing: If no required behavior is specified but the action has children (i.e. is a group), the required behavior is assumed to be could.

Cardinality: 0..1

Type: code

Binding: required:action-required-behavior

Mappings: rim=N/A

PlanDefinition.action.precheckBehavior

yes | no

Definition: Defines whether the action should usually be preselected.

Meaning if Missing: If no precheck behavior is specified but the action has children (i.e. is a group), the precheck behavior is assumed to be no.

Cardinality: 0..1

Type: code

Binding: required:action-precheck-behavior

Mappings: rim=N/A

PlanDefinition.action.cardinalityBehavior

single | multiple

Definition: Defines whether the action can be selected multiple times.

Meaning if Missing: If no cardinality behavior is specified but the action has children (i.e. is a group), the cardinality behavior is assumed to be single.

Cardinality: 0..1

Type: code

Binding: required:action-cardinality-behavior

Mappings: rim=N/A

PlanDefinition.action.definition[x]

Description of the activity to be performed

Definition: A reference to an ActivityDefinition that describes the action to be taken in detail, a Measure defining a measure to be evaluated, a MessageDefinition describing a message to be sent, a PlanDefinition that describes a series of actions to be taken, a Questionnaire that should be filled out, a SpecimenDefinition describing a specimen to be collected, an ObservationDefinition that specifies what observation should be captured, or an OperationDefinition that specifies what operation should be invoked. When the value is a uri, it is intended to be a reference to non-FHIR content that characterizes the action to be performed. This option is allowed to enable the PlanDefinition to be used to provide semi-structured representation, when the guidance is not computable, but there is still value in elaborating the overall structure with a PlanDefinition. The intended behavior when a definitionUri is realized as part of an apply is that it is copied to the resulting RequestOrchestration so that it is available to the consuming system. How that system interprets that uri is not specified.

Comments: Note that the definition is optional, and if no definition is specified, a dynamicValue with a root ($this) path can be used to define the entire resource dynamically. If the reference is to an ActivityDefinition or a PlanDefinition, the realization processing documented in those resources is followed. For the other definitional resource types, implementations SHOULD realize the action as a Task resource with a focus of the definitional resource to indicate that the activity should be carried out (e.g. evaluating a measure, gathering a specimen, filling out a questionnaire, sending a message, invoking an operation, etc.).

Cardinality: 0..1

Type: canonical, uri

Mappings: rim=Act[classCode=ACT; moodCode=DEFN]

PlanDefinition.action.transform

Transform to apply the template

Definition: A reference to a StructureMap resource that defines a transform that can be executed to produce the intent resource using the ActivityDefinition instance as the input.

Comments: Note that when a referenced ActivityDefinition also defines a transform, the transform specified here generally takes precedence. In addition, if both a transform and dynamic values are specific, the dynamic values are applied to the result of the transform.

Cardinality: 0..1

Type: canonical

Mappings: rim=N/A

PlanDefinition.action.dynamicValue

Dynamic aspects of the definition

Definition: Customizations that should be applied to the statically defined resource. For example, if the dosage of a medication must be computed based on the patient's weight, a customization would be used to specify an expression that calculated the weight, and the path on the resource that would contain the result.

Comments: Dynamic values are applied in the order in which they are defined in the PlanDefinition resource. Note that when dynamic values are also specified by a referenced ActivityDefinition, the dynamicValues from the ActivityDefinition are applied first, followed by the dynamicValues specified here. In addition, if both a transform and dynamic values are specific, the dynamic values are applied to the result of the transform.

Cardinality: 0..*

Type: BackboneElement

Mappings: rim=N/A

PlanDefinition.action.dynamicValue.path

The path to the element to be set dynamically

Definition: The path to the element to be customized. This is the path on the resource that will hold the result of the calculation defined by the expression. The specified path SHALL be a FHIRPath resolvable on the specified target type of the ActivityDefinition, and SHALL consist only of identifiers, constant indexers, and a restricted subset of functions. The path is allowed to contain qualifiers (.) to traverse sub-elements, as well as indexers ([x]) to traverse multiple-cardinality sub-elements (see the Simple FHIRPath Profile for full details).

Comments: To specify the path to the current action being realized, the %action environment variable is available in this path. For example, to specify the description element of the target action, the path would be %action.description. The path attribute contains a Simple FHIRPath Subset that allows path traversal, but not calculation.

Cardinality: 0..1

Type: string

Mappings: rim=N/A

PlanDefinition.action.dynamicValue.expression

An expression that provides the dynamic value for the customization

Definition: An expression specifying the value of the customized element.

Comments: The expression may be inlined or may be a reference to a named expression within a logic library referenced by the library element.

Cardinality: 0..1

Type: Expression

Mappings: rim=N/A

PlanDefinition.action.action

A sub-action

Definition: Sub actions that are contained within the action. The behavior of this action determines the functionality of the sub-actions. For example, a selection behavior of at-most-one indicates that of the sub-actions, at most one may be chosen as part of realizing the action definition.

Cardinality: 0..*

Mappings: workflow={InverseRelationship of Definition.partOf}; rim=N/A