Medizininformatik Initiative - Modul ICU - ImplementationGuide

Eingestellte und gemessene Parameter (DeviceMetric)

Canonical: https://www.medizininformatik-initiative.de/fhir/ext/modul-icu/StructureDefinition/devicemetric-eingestellte-gemessene-parameter-extrakorporale-verfahren

Empfehlung: Für gemessenen sowie eingestellten Werte können wir zwei Fälle unterscheiden (siehe hierzu auch die Seite Beschreibung Modul:

Das Gerät, welches den Messwert erhoben hat/bei dem ein Wert eingestellt wurde, ist bekannt und soll modelliert werden.
Das Gerät ist nicht bekannt und kann nicht modelliert werden sowie das Gerät ist bekannt und kann/soll nicht modelliert werden.

Die Information, ob der Wert gemessen, oder eingestellt ist, trägt die DeviceMetric, die Information, mit welchem Gerät dies geschehen ist, trägt eine Device-Ressource, welche aus der DeviceMetric heraus referenziert wird. Für die praktische Umsetzung obiger Punkte möchten wir folgende Vorschläge machen:

DeviceMetric und Device für einen solchen Messwert gehören zusammen. Für eine Gruppe von Werten, die sich eine gemeinsame Messmethode und ein gemeinsames Messgerät teilen, kann ein gemeinsames solches Paar aus DeviceMetric und Device angelegt werden, welche aus Observation.device heraus referenziert wird.
Wir schlagen vor, initial zwei "Dummy-Ressourcen" anzulegen. Je eine DeviceMetric für gemessene und eine für eingestellte Werte. Diese DeviceMetrics können dann statisch in allen Observation.device referenziert werden. Dies dient dazu, die minimal nötige Information zu tragen, ob ein Wert gemessen oder eingestellt ist. Dieses Vorgehen kann bei Bedarf weiter verfeinert werden, in dem man bspw. eine eigene DeviceMetric (je einmal gemessen/eingestellt) für jede Geräteart anlegt (für welche man dann jeweils eine entprechendes statisches Device unter DeviceMetric.device referenziert).

Differential

DeviceMetric	I		DeviceMetric	There are no (further) constraints on this element Element Id DeviceMetric Short description Measurement, calculation or setting capability of a medical device Definition Describes a measurement, calculation or setting capability of a medical device. Comments For the initial scope, this DeviceMetric resource is only applicable to describe a single metric node in the containment tree that is produced by the context scanner in any medical device that implements or derives from the ISO/IEEE 11073 standard. Data Type DeviceMetric Constraints 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()` Mappings rim:Entity. Role, or Act
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element Id DeviceMetric.identifier Short description Instance identifier Definition Unique instance identifiers assigned to a device by the device or gateway software, manufacturers, other organizations or owners. For example: handle ID. Comments For identifiers assigned to a device by the device or gateway software, the `system` element of the identifier should be set to the unique identifier of the device. Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier w5:FiveWs.identifier
type	S Σ	1..1	CodeableConceptBinding	Element Id DeviceMetric.type Short description Identity of metric, for example Heart Rate or PEEP Setting Definition Describes the type of the metric. For example: Heart Rate, PEEP Setting, etc. Comments DeviceMetric.type can be referred to either IEEE 11073-10101 or LOINC. Data Type CodeableConcept Binding Describes the metric type. VS_MII_ICU_Category_Procedure_Beatmung_SNOMED (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD w5:FiveWs.class
coding	S Σ	0..*	CodingPattern	Element Id DeviceMetric.type.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. 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. Data Type Coding Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "system": "http://snomed.info/sct", "code": "182744004" } Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding v2:CE.1-8, CE.10-22 rim:union(., ./translation) orim:fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
system	S Σ	1..1	uriFixed Value	There are no (further) constraints on this element Element Id DeviceMetric.type.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed Value http://snomed.info/sct Mappings rim:n/a v2:CE.3 rim:./codeSystem orim:*fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element Id DeviceMetric.type.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE.7 rim:./codeSystemVersion orim:*fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	S Σ	1..1	codeFixed Value	There are no (further) constraints on this element Element Id DeviceMetric.type.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed Value 182744004 Mappings rim:n/a v2:CE.1 rim:./code orim:*fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	0..1	string	There are no (further) constraints on this element Element Id DeviceMetric.type.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE.2 - but note this is not well followed rim:CV.displayName orim:*fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element Id DeviceMetric.type.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data Type boolean Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:Sometimes implied by being first rim:CD.codingRationale orim:fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element Id DeviceMetric.type.text Short description Plain text representation of the concept 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. 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. Comments Very often the text is the same as a displayName of one of the codings. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE.9. But note many systems use CE.2 for this rim:./originalText[mediaType/code="text/plain"]/data orim:fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
unit	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id DeviceMetric.unit Short description Unit of Measure for the Metric Definition Describes the unit that an observed value determined for this metric will have. For example: Percent, Seconds, etc. Comments DeviceMetric.unit can refer to either UCUM or preferable a RTMMS coding system. Data Type CodeableConcept Binding Describes the unit of the metric. DeviceMetricAndComponentTypes (preferred) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
source	S Σ I	0..1	MII-Reference(SD MII ICU ICU Device)	Element Id DeviceMetric.source Short description A reference from one resource to another Definition A reference from one resource to another. 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. Data Type MII-Reference(SD MII ICU ICU Device) Constraints 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'))` mii-reference-1:Either reference.reference OR reference.identifier exists `($this.reference.exists() or ($this.identifier.value.exists() and $this.identifier.system.exists())) xor $this.extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
parent	Σ I	0..1	Reference(Device)	There are no (further) constraints on this element Element Id DeviceMetric.parent Short description Describes the link to the parent Device Definition Describes the link to the Device that this DeviceMetric belongs to and that provide information about the location of this DeviceMetric in the containment structure of the parent Device. An example would be a Device that represents a Channel. This reference can be used by a client application to distinguish DeviceMetrics that have the same type, but should be interpreted based on their containment location. 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. Data Type Reference(Device) Constraints 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'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
operationalStatus	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id DeviceMetric.operationalStatus Short description on \| off \| standby \| entered-in-error Definition Indicates current operational state of the device. For example: On, Off, Standby, etc. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding Describes the operational status of the DeviceMetric. DeviceMetricOperationalStatus (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
color	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id DeviceMetric.color Short description black \| red \| green \| yellow \| blue \| magenta \| cyan \| white Definition Describes the color representation for the metric. This is often used to aid clinicians to track and identify parameter types by color. In practice, consider a Patient Monitor that has ECG/HR and Pleth for example; the parameters are displayed in different characteristic colors, such as HR-blue, BP-green, and PR and SpO2- magenta. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding Describes the typical color of representation. DeviceMetricColor (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
category	S Σ	1..1	codeBinding	There are no (further) constraints on this element Element Id DeviceMetric.category Short description measurement \| setting \| calculation \| unspecified Definition Indicates the category of the observation generation process. A DeviceMetric can be for example a setting, measurement, or calculation. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding Describes the category of the metric. DeviceMetricCategory (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a w5:FiveWs.class
measurementPeriod	Σ	0..1	Timing	There are no (further) constraints on this element Element Id DeviceMetric.measurementPeriod Short description Describes the measurement repetition time Definition Describes the measurement repetition time. This is not necessarily the same as the update period. The measurement repetition time can range from milliseconds up to hours. An example for a measurement repetition time in the range of milliseconds is the sampling rate of an ECG. An example for a measurement repetition time in the range of hours is a NIBP that is triggered automatically every hour. The update period may be different than the measurement repetition time, if the device does not update the published observed value with the same frequency as it was measured. Comments Describes the occurrence of an event that may occur multiple times. Timing schedules are used for specifying when events are expected or requested to occur, and may also be used to represent the summary of a past or ongoing event. For simplicity, the definitions of Timing components are expressed as 'future' events, but such components can also be used to describe historic or ongoing events. A Timing schedule can be a list of events and/or criteria for when the event happens, which can be expressed in a structured form and/or as a code. When both event and a repeating specification are provided, the list of events should be understood as an interpretation of the information in the repeat structure. Data Type Timing Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:QSET<TS> (GTS)
calibration	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element Id DeviceMetric.calibration Short description Describes the calibrations that have been performed or that are required to be performed Definition Describes the calibrations that have been performed or that are required to be performed. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
type	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id DeviceMetric.calibration.type Short description unspecified \| offset \| gain \| two-point Definition Describes the type of the calibration method. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding Describes the type of a metric calibration. DeviceMetricCalibrationType (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
state	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id DeviceMetric.calibration.state Short description not-calibrated \| calibration-required \| calibrated \| unspecified Definition Describes the state of the calibration. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding Describes the state of a metric calibration. DeviceMetricCalibrationState (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
time	Σ	0..1	instant	There are no (further) constraints on this element Element Id DeviceMetric.calibration.time Short description Describes the time last calibration has been performed Definition Describes the time last calibration has been performed. Comments Note: This is intended for where precisely observed times are required, typically system logs etc., and not human-reported times - for them, see date and dateTime (which can be as precise as instant, but is not required to be) below. Time zone is always required Data Type instant Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a

FHIR Element	Erklärung
DeviceMetric.type	Art der Prozedur (siehe Procedure.category) in deren Rahmen ein Wert erhoben wurde.
DeviceMetric.source	Wenn verfügbar, verknüpfung mit dem Gerät (Device).
DeviceMetric.category	Ob es sich um einen eingestellten oder gemessenen (oder anderweitig erhobenen) Wert handelt.

FHIR Element	Logischer Datensatz
DeviceMetric.type	Intensivmedizin.ParameterVonExtrakorporalenVerfahren
DeviceMetric.source	Intensivmedizin.Messmethode.Geraet
DeviceMetric.category	Nötig für die Zuordnung eines Wertes (Observation) zu entweder Intensivmedizin.ParameterVonExtrakorporalenVerfahren.ParameterGemessen oder Intensivmedizin.ParameterVonExtrakorporalenVerfahren.ParameterEingestellt

Snapshot

DeviceMetric	I		DeviceMetric	There are no (further) constraints on this element Element Id DeviceMetric Short description Measurement, calculation or setting capability of a medical device Definition Describes a measurement, calculation or setting capability of a medical device. Comments For the initial scope, this DeviceMetric resource is only applicable to describe a single metric node in the containment tree that is produced by the context scanner in any medical device that implements or derives from the ISO/IEEE 11073 standard. Data Type DeviceMetric Constraints 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()` Mappings rim:Entity. Role, or Act
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element Id DeviceMetric.identifier Short description Instance identifier Definition Unique instance identifiers assigned to a device by the device or gateway software, manufacturers, other organizations or owners. For example: handle ID. Comments For identifiers assigned to a device by the device or gateway software, the `system` element of the identifier should be set to the unique identifier of the device. Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier w5:FiveWs.identifier
type	S Σ	1..1	CodeableConceptBinding	Element Id DeviceMetric.type Short description Identity of metric, for example Heart Rate or PEEP Setting Definition Describes the type of the metric. For example: Heart Rate, PEEP Setting, etc. Comments DeviceMetric.type can be referred to either IEEE 11073-10101 or LOINC. Data Type CodeableConcept Binding Describes the metric type. VS_MII_ICU_Category_Procedure_Beatmung_SNOMED (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD w5:FiveWs.class
coding	S Σ	0..*	CodingPattern	Element Id DeviceMetric.type.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. 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. Data Type Coding Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "system": "http://snomed.info/sct", "code": "182744004" } Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding v2:CE.1-8, CE.10-22 rim:union(., ./translation) orim:fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
system	S Σ	1..1	uriFixed Value	There are no (further) constraints on this element Element Id DeviceMetric.type.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed Value http://snomed.info/sct Mappings rim:n/a v2:CE.3 rim:./codeSystem orim:*fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element Id DeviceMetric.type.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE.7 rim:./codeSystemVersion orim:*fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	S Σ	1..1	codeFixed Value	There are no (further) constraints on this element Element Id DeviceMetric.type.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed Value 182744004 Mappings rim:n/a v2:CE.1 rim:./code orim:*fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	0..1	string	There are no (further) constraints on this element Element Id DeviceMetric.type.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE.2 - but note this is not well followed rim:CV.displayName orim:*fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element Id DeviceMetric.type.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data Type boolean Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:Sometimes implied by being first rim:CD.codingRationale orim:fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element Id DeviceMetric.type.text Short description Plain text representation of the concept 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. 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. Comments Very often the text is the same as a displayName of one of the codings. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE.9. But note many systems use CE.2 for this rim:./originalText[mediaType/code="text/plain"]/data orim:fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
unit	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id DeviceMetric.unit Short description Unit of Measure for the Metric Definition Describes the unit that an observed value determined for this metric will have. For example: Percent, Seconds, etc. Comments DeviceMetric.unit can refer to either UCUM or preferable a RTMMS coding system. Data Type CodeableConcept Binding Describes the unit of the metric. DeviceMetricAndComponentTypes (preferred) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
source	S Σ I	0..1	MII-Reference(SD MII ICU ICU Device)	Element Id DeviceMetric.source Short description A reference from one resource to another Definition A reference from one resource to another. 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. Data Type MII-Reference(SD MII ICU ICU Device) Constraints 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'))` mii-reference-1:Either reference.reference OR reference.identifier exists `($this.reference.exists() or ($this.identifier.value.exists() and $this.identifier.system.exists())) xor $this.extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
parent	Σ I	0..1	Reference(Device)	There are no (further) constraints on this element Element Id DeviceMetric.parent Short description Describes the link to the parent Device Definition Describes the link to the Device that this DeviceMetric belongs to and that provide information about the location of this DeviceMetric in the containment structure of the parent Device. An example would be a Device that represents a Channel. This reference can be used by a client application to distinguish DeviceMetrics that have the same type, but should be interpreted based on their containment location. 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. Data Type Reference(Device) Constraints 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'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
operationalStatus	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id DeviceMetric.operationalStatus Short description on \| off \| standby \| entered-in-error Definition Indicates current operational state of the device. For example: On, Off, Standby, etc. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding Describes the operational status of the DeviceMetric. DeviceMetricOperationalStatus (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
color	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id DeviceMetric.color Short description black \| red \| green \| yellow \| blue \| magenta \| cyan \| white Definition Describes the color representation for the metric. This is often used to aid clinicians to track and identify parameter types by color. In practice, consider a Patient Monitor that has ECG/HR and Pleth for example; the parameters are displayed in different characteristic colors, such as HR-blue, BP-green, and PR and SpO2- magenta. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding Describes the typical color of representation. DeviceMetricColor (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
category	S Σ	1..1	codeBinding	There are no (further) constraints on this element Element Id DeviceMetric.category Short description measurement \| setting \| calculation \| unspecified Definition Indicates the category of the observation generation process. A DeviceMetric can be for example a setting, measurement, or calculation. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding Describes the category of the metric. DeviceMetricCategory (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a w5:FiveWs.class
measurementPeriod	Σ	0..1	Timing	There are no (further) constraints on this element Element Id DeviceMetric.measurementPeriod Short description Describes the measurement repetition time Definition Describes the measurement repetition time. This is not necessarily the same as the update period. The measurement repetition time can range from milliseconds up to hours. An example for a measurement repetition time in the range of milliseconds is the sampling rate of an ECG. An example for a measurement repetition time in the range of hours is a NIBP that is triggered automatically every hour. The update period may be different than the measurement repetition time, if the device does not update the published observed value with the same frequency as it was measured. Comments Describes the occurrence of an event that may occur multiple times. Timing schedules are used for specifying when events are expected or requested to occur, and may also be used to represent the summary of a past or ongoing event. For simplicity, the definitions of Timing components are expressed as 'future' events, but such components can also be used to describe historic or ongoing events. A Timing schedule can be a list of events and/or criteria for when the event happens, which can be expressed in a structured form and/or as a code. When both event and a repeating specification are provided, the list of events should be understood as an interpretation of the information in the repeat structure. Data Type Timing Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:QSET<TS> (GTS)
calibration	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element Id DeviceMetric.calibration Short description Describes the calibrations that have been performed or that are required to be performed Definition Describes the calibrations that have been performed or that are required to be performed. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
type	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id DeviceMetric.calibration.type Short description unspecified \| offset \| gain \| two-point Definition Describes the type of the calibration method. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding Describes the type of a metric calibration. DeviceMetricCalibrationType (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
state	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id DeviceMetric.calibration.state Short description not-calibrated \| calibration-required \| calibrated \| unspecified Definition Describes the state of the calibration. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding Describes the state of a metric calibration. DeviceMetricCalibrationState (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
time	Σ	0..1	instant	There are no (further) constraints on this element Element Id DeviceMetric.calibration.time Short description Describes the time last calibration has been performed Definition Describes the time last calibration has been performed. Comments Note: This is intended for where precisely observed times are required, typically system logs etc., and not human-reported times - for them, see date and dateTime (which can be as precise as instant, but is not required to be) below. Time zone is always required Data Type instant Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a

Eingestellt

{
    "resourceType": "DeviceMetric",
    "id": "BeispielEingestellteParameterEcmo",
    "meta": {
        "profile":  [
            "https://www.medizininformatik-initiative.de/fhir/ext/modul-icu/StructureDefinition/devicemetric-eingestellte-gemessene-parameter-extrakorporale-verfahren"
        ]
    },
    "type": {
        "coding":  [
            {
                "code": "182744004",
                "system": "http://snomed.info/sct",
                "display": "Extracorporeal circulation procedure (procedure)"
            }
        ]
    },
    "category": "setting"
}

Gemessen

{
    "resourceType": "DeviceMetric",
    "id": "BeispielGemesseneParameterEcmo",
    "meta": {
        "profile":  [
            "https://www.medizininformatik-initiative.de/fhir/ext/modul-icu/StructureDefinition/devicemetric-eingestellte-gemessene-parameter-extrakorporale-verfahren"
        ]
    },
    "type": {
        "coding":  [
            {
                "code": "182744004",
                "system": "http://snomed.info/sct",
                "display": "Extracorporeal circulation procedure (procedure)"
            }
        ]
    },
    "category": "measurement"
}