This page is part of the HSPC FHIR Implementation Guide (v0.1.0: Daft For Comment Draft) based on FHIR v1.9.0. This is the current published version. For a full list of available versions, see the Directory of published versions

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Profile hspc-alteredmentalstatus

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="hspc-alteredmentalstatus"/>
  <url
       value="http://fhir.org/guides/hspc/StructureDefinition/hspc-alteredmentalstatus"/>
  <name value="Profile hspc-alteredmentalstatus"/>
  <status value="draft"/>
  <publisher value="HSPC"/>
  <contact>
    <telecom>
      <system value="other"/>
      <value value="http://healthcaresoa.org"/>
    </telecom>
  </contact>
  <date value="2015-10-16"/>
  <mapping>
    <identity value="v2"/>
    <uri value="http://hl7.org/v2"/>
    <name value="HL7 v2 Mapping"/>
  </mapping>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <mapping>
    <identity value="w5"/>
    <uri value="http://hl7.org/fhir/w5"/>
    <name value="W5 Mapping"/>
  </mapping>
  <kind value="resource"/>
  <abstract value="false"/>
  <type value="Condition"/>
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Condition"/>
  <derivation value="constraint"/>
  <snapshot>
    <element id="Condition:hspcalteredmentalstatusassertion">
      <path value="Condition"/>
      <name value="HSPC Altered Mental Status Assertion"/>
      <short
             value="Detailed information about conditions, problems or diagnoses"/>
      <definition
                  value="Use to record detailed information about conditions, problems or diagnoses recognized by a clinician. There are many uses including: recording a diagnosis during an encounter; populating a problem list or a summary statement, such as a discharge summary."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Condition"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <mustSupport value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="PPR message"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="Observation[classCode=OBS, moodCode=EVN, code=ASSERTION, value<Diagnosis]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="clinical.general"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.id">
      <path value="Condition.id"/>
      <short value="Logical id of this artifact"/>
      <definition
                  value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
      <comments
                value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.meta">
      <path value="Condition.meta"/>
      <short value="Metadata about the resource"/>
      <definition
                  value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.meta"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.implicitRules">
      <path value="Condition.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition
                  value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content."/>
      <comments
                value="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 as much as possible."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.language">
      <path value="Condition.language"/>
      <short value="Language of the resource content"/>
      <definition value="The base language in which the resource is written."/>
      <comments
                value="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)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.language"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueReference>
            <reference value="http://hl7.org/fhir/ValueSet/all-languages"/>
          </valueReference>
        </extension>
        <strength value="extensible"/>
        <description value="A human language."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/languages"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.text">
      <path value="Condition.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition
                  value="A human-readable narrative that contains a summary of the resource, and may 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
                value="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 in formation is added later."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.text"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <condition value="dom-1"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.contained">
      <path value="Condition.contained"/>
      <short value="Contained, inline Resources"/>
      <definition
                  value="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
                value="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."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.extension">
      <path value="Condition.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the resource. In order 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."/>
      <comments
                value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.modifierExtension">
      <path value="Condition.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="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. Usually modifier elements provide negation or qualification. In order 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."/>
      <comments
                value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.identifier">
      <path value="Condition.identifier"/>
      <short value="External Ids for this condition"/>
      <definition
                  value="This records identifiers associated with this condition that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation)."/>
      <requirements value="Need to allow connection to a wider workflow."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Condition.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".id"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="id"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.clinicalStatus">
      <path value="Condition.clinicalStatus"/>
      <short value="active | relapse | remission | resolved"/>
      <definition value="The clinical status of the condition."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.clinicalStatus"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <description value="The clinical status of the condition or diagnosis."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/condition-clinical"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="PRB-14 / DG1-6"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="status"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.verificationStatus">
      <path value="Condition.verificationStatus"/>
      <short
             value="provisional | differential | confirmed | refuted | entered-in-error | unknown"/>
      <definition
                  value="The verification status to support the clinical status of the condition."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Condition.verificationStatus"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <description
                     value="The verification status to support or decline the clinical status of the condition or diagnosis."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/condition-ver-status"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="PRB-13"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".code (pre or post-coordinated in)  Can use valueNegationInd for refuted"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="status"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.category">
      <path value="Condition.category"/>
      <short value="complaint | symptom | finding | diagnosis"/>
      <definition value="A category assigned to the condition."/>
      <comments
                value="The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.category"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <strength value="preferred"/>
        <description value="A category assigned to the condition."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/condition-category"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map
             value="'problem' if from PRB-3. 'diagnosis' if from DG1 segment in PV1 message"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".code"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="class"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.severity">
      <path value="Condition.severity"/>
      <short value="Subjective severity of condition"/>
      <definition
                  value="A subjective assessment of the severity of the condition as evaluated by the clinician."/>
      <comments
                value="Coding of the severity with a terminology is preferred, where possible."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.severity"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <strength value="preferred"/>
        <description
                     value="A subjective assessment of the severity of the condition as evaluated by the clinician."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/condition-severity"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="PRB-26 / ABS-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="Can be pre/post-coordinated into value.  Or ./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="severity"].value"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="grade"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.code">
      <path value="Condition.code"/>
      <short value="Concept - reference to a terminology or just  text"/>
      <definition
                  value="A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text."/>
      <comments
                value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Condition.code"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/CodeableConcept"/>
      </type>
      <fixedCodeableConcept>
        <coding>
          <system value="http://snomed.info/sct"/>
          <code value="419284004"/>
          <display value="Altered mental status (finding)"/>
        </coding>
      </fixedCodeableConcept>
      <mustSupport value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="example"/>
        <description value="Identification of the condition or diagnosis."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/condition-code"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="CE/CNE/CWE"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CD"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.bodySite">
      <path value="Condition.bodySite"/>
      <short value="Anatomical location, if relevant"/>
      <definition
                  value="The anatomical location where this condition manifests itself."/>
      <comments
                value="May be a summary code, or a reference to a very precise definition of the location, or both."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Condition.bodySite"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="example"/>
        <description
                     value="Codes describing anatomical locations. May include laterality."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/body-site"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".targetBodySiteCode"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.subject">
      <path value="Condition.subject"/>
      <short value="Who has the condition?"/>
      <definition
                  value="Indicates the patient or group who the condition record is associated with."/>
      <requirements
                    value="Group is typically used for veterinary or public health use cases."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Condition.subject"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Group"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=SBJ].role[classCode=PAT]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.focus"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.context">
      <path value="Condition.context"/>
      <short value="Encounter when condition first asserted"/>
      <definition
                  value="Encounter during which the condition was first asserted."/>
      <comments
                value="This record indicates the encounter this particular record is associated with.  In the case of a "new" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first "known"."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.context"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PV1-19 (+PV1-54)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="context"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.onset[x]">
      <path value="Condition.onset[x]"/>
      <short value="Estimated or actual date,  date-time, or age"/>
      <definition
                  value="Estimated or actual date or date-time  the condition began, in the opinion of the clinician."/>
      <comments
                value="Age is generally used when the patient reports an age at which the Condition began to occur."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.onset[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="Age"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PRB-16"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".effectiveTime.low or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="age at onset"].value"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.init"/>
      </mapping>
    </element>
    <element
             id="Condition:hspcalteredmentalstatusassertion.abatementDateTime:dateofresolution">
      <path value="Condition.abatementDateTime"/>
      <name value="Date of Resolution"/>
      <short value="Primitive Type dateTime"/>
      <definition
                  value="A date, date-time or partial date (e.g. just year or year + month).  If hours and minutes are specified, a time zone SHALL be populated. The format is a union of the schema types gYear, gYearMonth, date and dateTime. Seconds must be provided due to schema type constraints but may be zero-filled and may be ignored.                 Dates SHALL be valid dates."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.abatement[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/dateTime"/>
      </type>
      <mustSupport value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.dateRecorded">
      <path value="Condition.dateRecorded"/>
      <short value="When first entered"/>
      <definition value="A date, when  the Condition statement was documented."/>
      <comments
                value="The Date Recorded represents the date when this particular Condition record was created in the EHR, not the date of the most recent update in terms of when severity, abatement, etc. were specified.  The date of the last record modification can be retrieved from the resource metadata."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.dateRecorded"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="date"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="REL-11"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=AUT].time"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.recorded"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.asserter">
      <path value="Condition.asserter"/>
      <short value="Person who asserts this condition"/>
      <definition value="Individual who is making the condition statement."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.asserter"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="REL-7.1 identifier + REL-7.12 type code"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=AUT].role"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.author"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.stage">
      <path value="Condition.stage"/>
      <short value="Stage/grade, usually assessed formally"/>
      <definition
                  value="Clinical stage or grade of a condition. May include formal severity assessments."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.stage"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="con-1"/>
        <severity value="error"/>
        <human value="Stage SHALL have summary or assessment"/>
        <expression value="summary.exists() or assessment.exists()"/>
        <xpath value="exists(f:summary) or exists(f:assessment)"/>
      </constraint>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map
             value="./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="stage/grade"]"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.stage.id">
      <path value="Condition.stage.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.stage.extension">
      <path value="Condition.stage.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order 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."/>
      <comments
                value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="Condition:hspcalteredmentalstatusassertion.stage.modifierExtension">
      <path value="Condition.stage.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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."/>
      <comments
                value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.stage.summary">
      <path value="Condition.stage.summary"/>
      <short value="Simple summary (disease specific)"/>
      <definition
                  value="A simple summary of the stage such as "Stage 3". The determination of the stage is disease-specific."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.stage.summary"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="con-1"/>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description
                     value="Codes describing condition stages (e.g. Cancer stages)."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/condition-stage"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="PRB-14"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".value"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.stage.assessment">
      <path value="Condition.stage.assessment"/>
      <short value="Formal record of assessment"/>
      <definition
                  value="Reference to a formal record of the evidence on which the staging assessment is based."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Condition.stage.assessment"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/ClinicalImpression"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
      </type>
      <condition value="con-1"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".self"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.evidence">
      <path value="Condition.evidence"/>
      <short value="Supporting evidence"/>
      <definition
                  value="Supporting Evidence / manifestations that are the basis on which this condition is suspected or confirmed."/>
      <comments
                value="The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Condition.evidence"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="con-2"/>
        <severity value="error"/>
        <human value="evidence SHALL have code or details"/>
        <expression value="code.exists() or detail.exists()"/>
        <xpath value="exists(f:code) or exists(f:detail)"/>
      </constraint>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=SPRT].target[classCode=OBS, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.evidence.id">
      <path value="Condition.evidence.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.evidence.extension">
      <path value="Condition.evidence.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order 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."/>
      <comments
                value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="Condition:hspcalteredmentalstatusassertion.evidence.modifierExtension">
      <path value="Condition.evidence.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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."/>
      <comments
                value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.evidence.code">
      <path value="Condition.evidence.code"/>
      <short value="Manifestation/symptom"/>
      <definition
                  value="A manifestation or symptom that led to the recording of this condition."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.evidence.code"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="con-2"/>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description
                     value="Codes that describe the manifestation or symptoms of a condition."/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/ValueSet/manifestation-or-symptom"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="[code="diagnosis"].value"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.evidence.detail">
      <path value="Condition.evidence.detail"/>
      <short value="Supporting information found elsewhere"/>
      <definition
                  value="Links to other relevant information, including pathology reports."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Condition.evidence.detail"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Resource"/>
      </type>
      <condition value="con-2"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".self"/>
      </mapping>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.note">
      <path value="Condition.note"/>
      <short value="Additional information about the Condition"/>
      <definition
                  value="Additional information about the Condition. This is a general notes/comments entry  for description of the Condition, its diagnosis and prognosis."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Condition.note"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Annotation"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="NTE child of PRB"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="Condition:hspcalteredmentalstatusassertion">
      <path value="Condition"/>
      <name value="HSPC Altered Mental Status Assertion"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.qicore-bodysite">
      <path value="Condition.qicore-bodysite"/>
      <min value="0"/>
      <max value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element
             id="Condition:hspcalteredmentalstatusassertion.extenstion:alleviatingfactor">
      <path value="Condition.extenstion"/>
      <name value="Alleviating Factor"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="preferred"/>
        <description
                     value="The set of concepts that describe actions or items that limit, reduce, or remove an identified condition or problem"/>
        <valueSetReference>
          <reference value="ValueSet/amsalleviatingfactors"/>
        </valueSetReference>
      </binding>
    </element>
    <element
             id="Condition:hspcalteredmentalstatusassertion.extenstion:exacerbatingfactor">
      <path value="Condition.extenstion"/>
      <name value="Exacerbating Factor"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="preferred"/>
        <description
                     value="The set of concepts that describe actions or items that increase or worsen an identified condition or problem."/>
        <valueSetReference>
          <reference value="ValueSet/amsexacerbatingfactors"/>
        </valueSetReference>
      </binding>
    </element>
    <element
             id="Condition:hspcalteredmentalstatusassertion.extenstion:periodicity">
      <path value="Condition.extenstion"/>
      <name value="Periodicity"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="preferred"/>
        <description
                     value="The set of concepts that describe the frequency that a condition or problem occurs."/>
        <valueSetReference>
          <reference value="ValueSet/amsperiodicity"/>
        </valueSetReference>
      </binding>
    </element>
    <element
             id="Condition:hspcalteredmentalstatusassertion.extenstion:associatedsignandsymptom">
      <path value="Condition.extenstion"/>
      <name value="Associated Sign and Symptom"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.extenstion:course">
      <path value="Condition.extenstion"/>
      <name value="Course"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="preferred"/>
        <description
                     value="The set of concepts tht describe the rate of change of a condition or problem as well as whether or not it is getting better or worse."/>
        <valueSetReference>
          <reference value="ValueSet/course"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.code">
      <path value="Condition.code"/>
      <type>
        <code value="CodeableConcept"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/CodeableConcept"/>
      </type>
      <fixedCodeableConcept>
        <coding>
          <system value="http://snomed.info/sct"/>
          <code value="419284004"/>
          <display value="Altered mental status (finding)"/>
        </coding>
      </fixedCodeableConcept>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Condition:hspcalteredmentalstatusassertion.bodySite">
      <path value="Condition.bodySite"/>
      <min value="0"/>
      <max value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element
             id="Condition:hspcalteredmentalstatusassertion.abatementDate:dateofresolution">
      <path value="Condition.abatementDate"/>
      <name value="Date of Resolution"/>
      <type>
        <code value="dateTime"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/dateTime"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
  </differential>
</StructureDefinition>