The data-requirements manifest generated for a compiled clinical criterion: a FHIR R4 Library with type = module-definition, declaring the resource types the logic retrieves, the profiles they must satisfy, the code and value-set filters applied, and the elements read. Derived from the compiled logic rather than authored beside it, so it cannot drift from the criteria it describes. A deployment artifact verified when a consuming host starts, not an API surface an application reaches.
Elements / Details
Every element this profile touches, with its full definition. Element names in the tables link here.
Criteria data requirements (module-definition Library)
Definition
What data one compiled clinical criterion reads: which resource types it retrieves, which
profiles those must satisfy, which code and value-set filters it applies, and which of their
elements the logic touches.
Derived from the compiled logic by static analysis, never authored beside it. A criteria
library that also carries a hand-written dataRequirement has two answers to the same
question and no way to tell which one the logic actually obeys; this is the one that cannot
be wrong.
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.
A set of rules under which this content was created
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.
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.
Cardinality
0..1
Type
uri
Modifier
yes — 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
The base language in which the resource is written.
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).
Text summary of the resource, for human interpretation
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.
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.
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.
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.
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.
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.
Whether membership can change through the passage of time alone -- always present
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.
Comments
Required, including when false. Reading an absent value as false would silently skip a periodic sweep that a time-anchored cohort needed, and the cohort would go stale with every surface still reporting success.
One element path per repetition, bounding what a projection must materialise
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.
Comments
Repeats, one path per occurrence, and never packs several into one delimited string. Paths are flat across every resource type the manifest retrieves and carry no type prefix, so sizing a per-resource projection means intersecting this list with the types in dataRequirement rather than reading it directly.
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).
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.
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.
Cardinality
0..*
Type
Extension
Modifier
yes — Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Canonical URL of this manifest, minted per criterion
Definition
An absolute URI that is used to identify this library 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 at which an authoritative instance of this library is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the library is stored on different servers.
Requirements
Allows the library to be referenced by a single globally unique identifier.
Comments
Minted from the pack's canonical base as .../Library/<criterion>-requirements, so it is stable for a given criterion and derivable without opening the file. Two criteria in one pack claiming one canonical is a pack whose consumer cannot resolve an include, and is refused at generation.
A formal identifier that is used to identify this library when it is represented in other formats, or referenced in a specification, model, design or an instance. e.g. CMS or NQF identifiers for a measure artifact. Note that at least one identifier is required for non-experimental active artifacts.
Requirements
Allows externally provided and/or usable business identifiers to be easily associated with the module.
Comments
Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this library outside of FHIR, where it is not possible to use the logical URI.
The identifier that is used to identify this version of the library when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the library 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
Also read back out of the compiled logic. Together with name this is the identity an include in another criteria library resolves against.
The compiled library's own identifier, machine-readable
Definition
A natural language name identifying the library. This name should be usable as an identifier for the module by machine processing applications such as code generation.
Requirements
Support human navigation and code generation.
Comments
Read back out of the compiled logic rather than restated: it is the identifier the criteria library declares for itself, so a manifest and the ELM beside it cannot disagree about which criterion they describe.
A Boolean value to indicate that this library is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.
Requirements
Enables experimental content to be developed following the same lifecycle that would be used for a production-level library.
Comments
Allows filtering of librarys that are appropriate for use versus not.
Always module-definition -- this Library declares requirements, it does not carry content
Definition
Identifies the type of library such as a Logic Library, Model Definition, Asset Collection, or Module Definition.
Comments
The element that separates this shape from the other Library kind published here. A model-definition Library carries a ModelInfo attachment and no dataRequirement, and is a different resource with a different purpose; do not read one as the other.
The date (and optionally time) when the library was published. 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 library changes.
Comments
Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the library. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.
Name of the publisher (organization or individual)
Definition
The name of the organization or individual that published the library.
Requirements
Helps establish the "authority/credibility" of the library. May also allow for contact.
Comments
Usually an organization but may be an individual. The publisher (or steward) of the library is the organization or individual primarily responsible for the maintenance and upkeep of the library. 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 library. This item SHOULD be populated unless the information is available from context.
A free text natural language description of the library from a consumer's perspective.
Comments
This description can be used to capture details such as why the library was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the library 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 library is presumed to be the predominant language in the place the library was created).
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 library instances.
Requirements
Assist in searching for appropriate content.
Comments
When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.
Explanation of why this library is needed and why it has been designed as it has.
Comments
This element does not describe the usage of the library. 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 library.
A copyright statement relating to the library and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the library.
Requirements
Consumers must be able to determine any legal restrictions on the use of the library and/or its content.
The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.
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.
Comments
If specified, this date follows the original approval date.
The period during which the library content was or is planned to be in active use.
Requirements
Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of the library are or are expected to be used instead.
Comments
The effective period for a library determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015.
Descriptive topics related to the content of the library. Topics provide a high-level categorization of the library that can be useful for filtering and searching.
Requirements
Repositories must be able to determine how to categorize the library so that it can be found by topical searches.
Related artifacts such as additional documentation, justification, or bibliographic references.
Requirements
Libraries 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.
Comments
Each related artifact is either an attachment, or a reference to another resource, but not both.
The resource types the logic retrieves, with their profiles and filters
Definition
One entry per distinct retrieve the compiled logic performs. type is the FHIR resource type,
profile names the profile the retrieve was bound against, and codeFilter carries the code or
value-set restriction applied to it.
This is what bounds a FETCH: union type across a deployment's criteria estate and the result is
the set of resource types an initial load has to cover. What bounds a PROJECTION is finer and is
carried separately, on the criteriaElementsRead extension below.
Comments
Never empty. A manifest with no data requirement is not a criterion with no inputs, it is an analysis that produced nothing useful, and the two are indistinguishable from the artifact alone.
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.
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.
The type of the required data, specified as the type name of a resource. For profiles, this value is set to the type of the base resource of the profile.
E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device
Definition
The intended subjects of the data requirement. If this element is not provided, a Patient subject is assumed.
Comments
The subject of a data requirement is critical, as the data being specified is determined with respect to a particular subject. This corresponds roughly to the notion of a Compartment in that it limits what data is available based on its relationship to the subject. In CQL, this corresponds to the context declaration.
Indicates specific structure elements that are referenced by the knowledge module
Definition
Indicates that specific elements of the type are referenced by the knowledge module and must be supported by the consumer in order to obtain an effective evaluation. This does not mean that a value is required for this element, only that the consuming system must understand the element and be able to provide values for it if they are available.
The value of mustSupport SHALL be a FHIRPath resolveable on the type of the DataRequirement. The path SHALL consist only of identifiers, constant indexers, and .resolve() (see the Simple FHIRPath Profile for full details).
Code filters specify additional constraints on the data, specifying the value set of interest for a particular element of the data. Each code filter defines an additional constraint on the data, i.e. code filters are AND'ed, not OR'ed.
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.
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.
The element the codes apply to -- always present on a generated manifest
Definition
The code-valued attribute of the filter. The specified path SHALL be a FHIRPath resolveable on the specified type of the DataRequirement, and SHALL consist only of identifiers, constant indexers, and .resolve(). 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). Note that the index must be an integer constant. The path must resolve to an element of type code, Coding, or CodeableConcept.
Comments
A path relative to the retrieved resource (code, medication). Where the retrieved profile declares a primary code path, this is that element; where it declares none, a bare code filter is refused at generation rather than quietly matched against the wrong element. searchParam is not used as an alternative here.
A token parameter that refers to a search parameter defined on the specified type of the DataRequirement, and which searches on elements of type code, Coding, or CodeableConcept.
The valueset for the code filter. The valueSet and code elements are additive. If valueSet is specified, the filter will return only those data items for which the value of the code-valued element specified in the path is a member of the specified valueset.
The codes for the code filter. If values are given, the filter will return only those data items for which the code-valued attribute specified by the path has a value that is one of the specified codes. If codes are specified in addition to a value set, the filter returns items matching a code in the value set or one of the specified codes.
Date filters specify additional constraints on the data in terms of the applicable date range for specific elements. Each date filter specifies an additional constraint on the data, i.e. date filters are AND'ed, not OR'ed.
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.
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.
The date-valued attribute of the filter. The specified path SHALL be a FHIRPath resolveable on the specified type of the DataRequirement, and SHALL consist only of identifiers, constant indexers, and .resolve(). 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). Note that the index must be an integer constant. The path must resolve to an element of type date, dateTime, Period, Schedule, or Timing.
Comments
The path attribute contains a Simple FHIR Subset that allows path traversal, but not calculation.
A date parameter that refers to a search parameter defined on the specified type of the DataRequirement, and which searches on elements of type date, dateTime, Period, Schedule, or Timing.
The value of the filter, as a Period, DateTime, or Duration value
Definition
The value of the filter. If period is specified, the filter will return only those data items that fall within the bounds determined by the Period, inclusive of the period boundaries. If dateTime is specified, the filter will return only those data items that are equal to the specified dateTime. If a Duration is specified, the filter will return only those data items that fall within Duration before now.
Specifies the order of the results to be returned.
Requirements
Enables the requirement "most recent 5 results" to be expressed.
Comments
This element can be used in combination with the sort element to specify quota requirements such as "the most recent 5" or "the highest 5". When multiple sorts are specified, they are applied in the order they appear in the resource.
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.
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.
The attribute of the sort. The specified path must be resolvable from the type of the required data. The path is allowed to contain qualifiers (.) to traverse sub-elements, as well as indexers ([x]) to traverse multiple-cardinality sub-elements. Note that the index must be an integer constant.
Contents of the library, either embedded or referenced
Definition
The content of the library as an Attachment. The content may be a reference to a url, or may be directly embedded as a base-64 string. Either way, the contentType of the attachment determines how to interpret the content.