HL7 FHIR Profile: Skin and Wound Assessment, Release 1 (For Comment)
<StructureDefinition xmlns="http://hl7.org/fhir"> <id value="fsw-WoundAssessment-model"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"> <p><b>SW WoundAssessment Logical Model</b></p> <p>LOINC 39135-9 (Wound assessment panel)</p> </div> </text> <url value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-WoundAssessment-model"/> <identifier> <system value="http://hl7.org/fhir/us/fsw"/> <value value="fsw.WoundAssessment"/> </identifier> <version value="1.0.0"/> <name value="WoundAssessmentModel"/> <title value="SW WoundAssessment Logical Model"/> <status value="draft"/> <date value="2018-08-21T00:00:00-04:00"/> <publisher value="HL7 Patient Care and Clinical Information Modeling Initiative Work Groups"/> <contact> <telecom> <system value="url"/> <value value="http://standardhealthrecord.org"/> </telecom> </contact> <description value="LOINC 39135-9 (Wound assessment panel)"/> <keyword> <system value="http://loinc.org"/> <code value="39135-9"/> <display value="LNC#72287-6"/> </keyword> <kind value="logical"/> <abstract value="false"/> <type value="fsw-WoundAssessment-model"/> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Element"/> <derivation value="specialization"/> <snapshot> <element id="fsw-WoundAssessment-model"> <path value="fsw-WoundAssessment-model"/> <definition value="LOINC 39135-9 (Wound assessment panel)"/> <min value="0"/> <max value="*"/> <base> <path value="fsw-WoundAssessment-model"/> <min value="0"/> <max value="*"/> </base> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.value[x]"> <path value="fsw-WoundAssessment-model.value[x]"/> <short value="Code or Quantity representing lOINC 39135-9 (Wound assessment panel)"/> <definition value="Code or Quantity representing lOINC 39135-9 (Wound assessment panel)"/> <min value="1"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.value[x]"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <type> <code value="http://hl7.org/fhir/us/fsw/StructureDefinition/shr-core-Quantity-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.comment"> <path value="fsw-WoundAssessment-model.comment"/> <short value="Description"/> <definition value="Description"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.comment"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.topicCode"> <path value="fsw-WoundAssessment-model.topicCode"/> <short value="The concept representing the finding or action that is the topic of the statement."/> <definition value="The concept representing the finding or action that is the topic of the statement. For action topics, the TopicCode represents the action being described. For findings, the TopicCode represents the 'question' or property being investigated. For evaluation result findings, the TopicCode contains a concept for an observable entity, such as systolic blood pressure. For assertion findings, the TopicCode contains a code representing the condition, allergy, or other item being asserted. In all cases, the TopicCode describes the topic of the action or the finding."/> <min value="1"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.topicCode"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.category"> <path value="fsw-WoundAssessment-model.category"/> <short value="Description"/> <definition value="Description"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.category"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.dataAbsentReason"> <path value="fsw-WoundAssessment-model.dataAbsentReason"/> <short value="Description"/> <definition value="Description"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.dataAbsentReason"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.dateTime"> <path value="fsw-WoundAssessment-model.dateTime"/> <short value="Description"/> <definition value="Description"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.dateTime"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.dateTimeIssued"> <path value="fsw-WoundAssessment-model.dateTimeIssued"/> <short value="Description"/> <definition value="Description"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.dateTimeIssued"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.description"> <path value="fsw-WoundAssessment-model.description"/> <short value="Description"/> <definition value="Description"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.description"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/fsw/StructureDefinition/shr-base-Narrative-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.evaluationComponent"> <path value="fsw-WoundAssessment-model.evaluationComponent"/> <short value="A simplified, non-separable evaluation consisting of a finding code (represented by the Concept), value (or exception value), reference range, and interpretation. The subject of the evaluation component is the same as in the parent evaluation."/> <definition value="A simplified, non-separable evaluation consisting of a finding code (represented by the Concept), value (or exception value), reference range, and interpretation. The subject of the evaluation component is the same as in the parent evaluation."/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.evaluationComponent"/> <min value="0"/> <max value="1"/> </base> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.evaluationComponent.isExudatePresent"> <path value="fsw-WoundAssessment-model.evaluationComponent.isExudatePresent"/> <code> <system value="http://loinc.org"/> <code value="89259-6"/> </code> <short value="Presence or absence of wound drainage. - LOINC 89259-6 (Presence of wound exudate) In Loinc this is a code with Yes, No values"/> <definition value="Presence or absence of wound drainage. - LOINC 89259-6 (Presence of wound exudate) In Loinc this is a code with Yes, No values"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.evaluationComponent.isExudatePresent"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-IsExudatePresent-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.evaluationComponent.isTunnelingPresent"> <path value="fsw-WoundAssessment-model.evaluationComponent.isTunnelingPresent"/> <code> <system value="http://loinc.org"/> <code value="72298-3"/> </code> <short value="Tunneling of a wound refers to a narrow opening or pathway underneath the skin that may extend in any direction, resulting in dead space with potential for abscess formation. - LOINC 72298-3 (Tunneling of Wound) In Loinc this is a code with Yes, No values"/> <definition value="Tunneling of a wound refers to a narrow opening or pathway underneath the skin that may extend in any direction, resulting in dead space with potential for abscess formation. - LOINC 72298-3 (Tunneling of Wound) In Loinc this is a code with Yes, No values"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.evaluationComponent.isTunnelingPresent"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-IsTunnelingPresent-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.evaluationComponent.isUnderminingPresent"> <path value="fsw-WoundAssessment-model.evaluationComponent.isUnderminingPresent"/> <code> <system value="http://loinc.org"/> <code value="72295-9"/> </code> <short value="Undermining of a wound refers to tissue destruction that extends under the intact wound edge. The wound is larger at its base (wound bed) than at the skin surface. With pressure ulcers, undermining may be caused by a bacterial infection or associated with osteomyelitis. - LOINC 72295-9 (Undermining of Wound) In Loinc this is a code with Yes, No values"/> <definition value="Undermining of a wound refers to tissue destruction that extends under the intact wound edge. The wound is larger at its base (wound bed) than at the skin surface. With pressure ulcers, undermining may be caused by a bacterial infection or associated with osteomyelitis. - LOINC 72295-9 (Undermining of Wound) In Loinc this is a code with Yes, No values"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.evaluationComponent.isUnderminingPresent"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-IsUnderminingPresent-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.evaluationComponent.periwoundDescription"> <path value="fsw-WoundAssessment-model.evaluationComponent.periwoundDescription"/> <code> <system value="http://loinc.org"/> <code value="72301-5"/> </code> <short value="A description of the skin around the wound (periwound). Color, induration, warmth and edema should be assessed. Redness of the surrounding skin can be indicative of unrelieved pressure. Irritation of the surrounding skin can result from exposure to feces or urine, a reaction to the dressing or tape, or inappropriate removal of dressing or tape. Redness, tenderness, warmth and swelling are classical clinical signs of infection. [Reference: Brown, P., 2009] - LOINC 72301-5 (Description of Periwound)"/> <definition value="A description of the skin around the wound (periwound). Color, induration, warmth and edema should be assessed. Redness of the surrounding skin can be indicative of unrelieved pressure. Irritation of the surrounding skin can result from exposure to feces or urine, a reaction to the dressing or tape, or inappropriate removal of dressing or tape. Redness, tenderness, warmth and swelling are classical clinical signs of infection. [Reference: Brown, P., 2009] - LOINC 72301-5 (Description of Periwound)"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.evaluationComponent.periwoundDescription"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-PeriwoundDescription-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.evaluationComponent.pressureUlcerStage"> <path value="fsw-WoundAssessment-model.evaluationComponent.pressureUlcerStage"/> <code> <system value="http://loinc.org"/> <code value="72527-5"/> </code> <short value="The National Pressure Ulcer Advisory Panel redefined the definition of a pressure ulcer and the stages of pressure ulcers in 2007, including the original 4 stages (Non-blanchable erythema - Stage I, partial thickness – Stage II, full thickness skin loss – Stage III, and full thickness tissue loss – Stage IV) and adding 2 stages on deep tissue injury and unstageable pressure ulcers. As defined by the NPUAP, a pressure ulcer is localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear. - LOINC 72527-5 (Pressure ulcer stage NPUAP)"/> <definition value="The National Pressure Ulcer Advisory Panel redefined the definition of a pressure ulcer and the stages of pressure ulcers in 2007, including the original 4 stages (Non-blanchable erythema - Stage I, partial thickness – Stage II, full thickness skin loss – Stage III, and full thickness tissue loss – Stage IV) and adding 2 stages on deep tissue injury and unstageable pressure ulcers. As defined by the NPUAP, a pressure ulcer is localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear. - LOINC 72527-5 (Pressure ulcer stage NPUAP)"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.evaluationComponent.pressureUlcerStage"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-PressureUlcerStage-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.evaluationComponent.visibleStructure"> <path value="fsw-WoundAssessment-model.evaluationComponent.visibleStructure"/> <code> <system value="http://loinc.org"/> <code value="89250-5"/> </code> <short value="Exposed body structures, devices, and/or foreign bodies visible by the naked eye in a wound. - LOINC 89250-5 (Device or anatomic structure visible in wound)"/> <definition value="Exposed body structures, devices, and/or foreign bodies visible by the naked eye in a wound. - LOINC 89250-5 (Device or anatomic structure visible in wound)"/> <min value="0"/> <max value="*"/> <base> <path value="fsw-WoundAssessment-model.evaluationComponent.visibleStructure"/> <min value="0"/> <max value="*"/> </base> <type> <code value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-VisibleStructure-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.evaluationComponent.woundHealingAssessment"> <path value="fsw-WoundAssessment-model.evaluationComponent.woundHealingAssessment"/> <code> <system value="http://loinc.org"/> <code value="80338-7"/> </code> <short value="- LOINC 80338-7 (Wound assessment [Interpretation])"/> <definition value="- LOINC 80338-7 (Wound assessment [Interpretation])"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.evaluationComponent.woundHealingAssessment"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-WoundHealingAssessment-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.evaluationComponent.woundTrend"> <path value="fsw-WoundAssessment-model.evaluationComponent.woundTrend"/> <code> <system value="http://loinc.org"/> <code value="89253-9"/> </code> <short value="Whether a condition is improving, worsening, stable, or resolved. - LOINC 89253-9 (Trend)"/> <definition value="Whether a condition is improving, worsening, stable, or resolved. - LOINC 89253-9 (Trend)"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.evaluationComponent.woundTrend"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-WoundTrend-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.interpretation"> <path value="fsw-WoundAssessment-model.interpretation"/> <short value="Description"/> <definition value="Description"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.interpretation"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.method"> <path value="fsw-WoundAssessment-model.method"/> <short value="Description"/> <definition value="Description"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.method"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.resultStatus"> <path value="fsw-WoundAssessment-model.resultStatus"/> <short value="Description"/> <definition value="Description"/> <min value="1"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.resultStatus"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <strength value="required"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-status"/> </valueSetReference> </binding> </element> <element id="fsw-WoundAssessment-model.panelMembers"> <path value="fsw-WoundAssessment-model.panelMembers"/> <short value="PanelMembers represent the elements of a group of a related but independent evaluations."/> <definition value="PanelMembers represent the elements of a group of a related but independent evaluations. Examples are the measurements that compose a complete blood count (CBC), or the elements of a pathology report. Each member is an independent evaluation, but the grouping reflects a composite lab order, shared specimen, or a single report author. Typically the Category and Reason are not given for individual findings that are part of the panel, but rather given at the level of the panel itself."/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.panelMembers"/> <min value="0"/> <max value="1"/> </base> <type> <code value="BackboneElement"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.panelMembers.observationStatement"> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement"/> <short value="A base class for representing observed facts, including provenance"/> <definition value="A base class for representing observed facts, including provenance"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement"/> <min value="0"/> <max value="1"/> </base> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.panelMembers.observationStatement.woundAssertion"> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundAssertion"/> <code> <system value="http://loinc.org"/> <code value="72287-6"/> <display value="LNC#72287-6"/> </code> <short value="Assertion of the existence of a wound on a patient"/> <definition value="Assertion of the existence of a wound on a patient"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundAssertion"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-WoundAssertion-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.panelMembers.observationStatement.woundBed"> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundBed"/> <code> <system value="http://loinc.org"/> <code value="72287-6"/> <display value="LNC#72287-6"/> </code> <short value="- LOINC 72372-6 (Wound bed and edge panel)"/> <definition value="- LOINC 72372-6 (Wound bed and edge panel)"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundBed"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-WoundBed-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.panelMembers.observationStatement.woundEdge"> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundEdge"/> <code> <system value="http://loinc.org"/> <code value="72287-6"/> <display value="LNC#72287-6"/> </code> <short value="- LOINC 89256-2 (Wound edge panel)"/> <definition value="- LOINC 89256-2 (Wound edge panel)"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundEdge"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-WoundEdge-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.panelMembers.observationStatement.woundExudate"> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundExudate"/> <code> <system value="http://loinc.org"/> <code value="72287-6"/> <display value="LNC#72287-6"/> </code> <short value="- LOINC 72292-6 (Wound exudate panel)"/> <definition value="- LOINC 72292-6 (Wound exudate panel)"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundExudate"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-WoundExudate-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.panelMembers.observationStatement.woundSize"> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundSize"/> <code> <system value="http://loinc.org"/> <code value="72287-6"/> <display value="LNC#72287-6"/> </code> <short value="- LOINC 72287-6 (Wound size panel)"/> <definition value="- LOINC 72287-6 (Wound size panel)"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundSize"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-WoundSize-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.panelMembers.observationStatement.woundTunneling"> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundTunneling"/> <code> <system value="http://loinc.org"/> <code value="72287-6"/> <display value="LNC#72287-6"/> </code> <short value="LOINC 89257-0 (Wound tunneling panel)"/> <definition value="LOINC 89257-0 (Wound tunneling panel)"/> <min value="0"/> <max value="*"/> <base> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundTunneling"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-WoundTunneling-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.panelMembers.observationStatement.woundUndermining"> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundUndermining"/> <code> <system value="http://loinc.org"/> <code value="89258-8"/> <display value="LNC#89258-8"/> </code> <short value="LOINC 89258-8 (Wound undermining panel)"/> <definition value="LOINC 89258-8 (Wound undermining panel)"/> <min value="0"/> <max value="*"/> <base> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundUndermining"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-WoundUndermining-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> </snapshot> <differential> <element id="fsw-WoundAssessment-model"> <path value="fsw-WoundAssessment-model"/> <definition value="LOINC 39135-9 (Wound assessment panel)"/> <min value="0"/> <max value="*"/> <base> <path value="fsw-WoundAssessment-model"/> <min value="0"/> <max value="*"/> </base> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.value[x]"> <path value="fsw-WoundAssessment-model.value[x]"/> <short value="Code or Quantity representing lOINC 39135-9 (Wound assessment panel)"/> <definition value="Code or Quantity representing lOINC 39135-9 (Wound assessment panel)"/> <min value="1"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.value[x]"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <type> <code value="http://hl7.org/fhir/us/fsw/StructureDefinition/shr-core-Quantity-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.comment"> <path value="fsw-WoundAssessment-model.comment"/> <short value="Description"/> <definition value="Description"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.comment"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.topicCode"> <path value="fsw-WoundAssessment-model.topicCode"/> <short value="The concept representing the finding or action that is the topic of the statement."/> <definition value="The concept representing the finding or action that is the topic of the statement. For action topics, the TopicCode represents the action being described. For findings, the TopicCode represents the 'question' or property being investigated. For evaluation result findings, the TopicCode contains a concept for an observable entity, such as systolic blood pressure. For assertion findings, the TopicCode contains a code representing the condition, allergy, or other item being asserted. In all cases, the TopicCode describes the topic of the action or the finding."/> <min value="1"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.topicCode"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.category"> <path value="fsw-WoundAssessment-model.category"/> <short value="Description"/> <definition value="Description"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.category"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.dataAbsentReason"> <path value="fsw-WoundAssessment-model.dataAbsentReason"/> <short value="Description"/> <definition value="Description"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.dataAbsentReason"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.dateTime"> <path value="fsw-WoundAssessment-model.dateTime"/> <short value="Description"/> <definition value="Description"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.dateTime"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.dateTimeIssued"> <path value="fsw-WoundAssessment-model.dateTimeIssued"/> <short value="Description"/> <definition value="Description"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.dateTimeIssued"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.description"> <path value="fsw-WoundAssessment-model.description"/> <short value="Description"/> <definition value="Description"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.description"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/fsw/StructureDefinition/shr-base-Narrative-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.evaluationComponent"> <path value="fsw-WoundAssessment-model.evaluationComponent"/> <short value="A simplified, non-separable evaluation consisting of a finding code (represented by the Concept), value (or exception value), reference range, and interpretation. The subject of the evaluation component is the same as in the parent evaluation."/> <definition value="A simplified, non-separable evaluation consisting of a finding code (represented by the Concept), value (or exception value), reference range, and interpretation. The subject of the evaluation component is the same as in the parent evaluation."/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.evaluationComponent"/> <min value="0"/> <max value="1"/> </base> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.evaluationComponent.isExudatePresent"> <path value="fsw-WoundAssessment-model.evaluationComponent.isExudatePresent"/> <code> <system value="http://loinc.org"/> <code value="89259-6"/> </code> <short value="Presence or absence of wound drainage. - LOINC 89259-6 (Presence of wound exudate) In Loinc this is a code with Yes, No values"/> <definition value="Presence or absence of wound drainage. - LOINC 89259-6 (Presence of wound exudate) In Loinc this is a code with Yes, No values"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.evaluationComponent.isExudatePresent"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-IsExudatePresent-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.evaluationComponent.isTunnelingPresent"> <path value="fsw-WoundAssessment-model.evaluationComponent.isTunnelingPresent"/> <code> <system value="http://loinc.org"/> <code value="72298-3"/> </code> <short value="Tunneling of a wound refers to a narrow opening or pathway underneath the skin that may extend in any direction, resulting in dead space with potential for abscess formation. - LOINC 72298-3 (Tunneling of Wound) In Loinc this is a code with Yes, No values"/> <definition value="Tunneling of a wound refers to a narrow opening or pathway underneath the skin that may extend in any direction, resulting in dead space with potential for abscess formation. - LOINC 72298-3 (Tunneling of Wound) In Loinc this is a code with Yes, No values"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.evaluationComponent.isTunnelingPresent"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-IsTunnelingPresent-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.evaluationComponent.isUnderminingPresent"> <path value="fsw-WoundAssessment-model.evaluationComponent.isUnderminingPresent"/> <code> <system value="http://loinc.org"/> <code value="72295-9"/> </code> <short value="Undermining of a wound refers to tissue destruction that extends under the intact wound edge. The wound is larger at its base (wound bed) than at the skin surface. With pressure ulcers, undermining may be caused by a bacterial infection or associated with osteomyelitis. - LOINC 72295-9 (Undermining of Wound) In Loinc this is a code with Yes, No values"/> <definition value="Undermining of a wound refers to tissue destruction that extends under the intact wound edge. The wound is larger at its base (wound bed) than at the skin surface. With pressure ulcers, undermining may be caused by a bacterial infection or associated with osteomyelitis. - LOINC 72295-9 (Undermining of Wound) In Loinc this is a code with Yes, No values"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.evaluationComponent.isUnderminingPresent"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-IsUnderminingPresent-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.evaluationComponent.periwoundDescription"> <path value="fsw-WoundAssessment-model.evaluationComponent.periwoundDescription"/> <code> <system value="http://loinc.org"/> <code value="72301-5"/> </code> <short value="A description of the skin around the wound (periwound). Color, induration, warmth and edema should be assessed. Redness of the surrounding skin can be indicative of unrelieved pressure. Irritation of the surrounding skin can result from exposure to feces or urine, a reaction to the dressing or tape, or inappropriate removal of dressing or tape. Redness, tenderness, warmth and swelling are classical clinical signs of infection. [Reference: Brown, P., 2009] - LOINC 72301-5 (Description of Periwound)"/> <definition value="A description of the skin around the wound (periwound). Color, induration, warmth and edema should be assessed. Redness of the surrounding skin can be indicative of unrelieved pressure. Irritation of the surrounding skin can result from exposure to feces or urine, a reaction to the dressing or tape, or inappropriate removal of dressing or tape. Redness, tenderness, warmth and swelling are classical clinical signs of infection. [Reference: Brown, P., 2009] - LOINC 72301-5 (Description of Periwound)"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.evaluationComponent.periwoundDescription"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-PeriwoundDescription-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.evaluationComponent.pressureUlcerStage"> <path value="fsw-WoundAssessment-model.evaluationComponent.pressureUlcerStage"/> <code> <system value="http://loinc.org"/> <code value="72527-5"/> </code> <short value="The National Pressure Ulcer Advisory Panel redefined the definition of a pressure ulcer and the stages of pressure ulcers in 2007, including the original 4 stages (Non-blanchable erythema - Stage I, partial thickness – Stage II, full thickness skin loss – Stage III, and full thickness tissue loss – Stage IV) and adding 2 stages on deep tissue injury and unstageable pressure ulcers. As defined by the NPUAP, a pressure ulcer is localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear. - LOINC 72527-5 (Pressure ulcer stage NPUAP)"/> <definition value="The National Pressure Ulcer Advisory Panel redefined the definition of a pressure ulcer and the stages of pressure ulcers in 2007, including the original 4 stages (Non-blanchable erythema - Stage I, partial thickness – Stage II, full thickness skin loss – Stage III, and full thickness tissue loss – Stage IV) and adding 2 stages on deep tissue injury and unstageable pressure ulcers. As defined by the NPUAP, a pressure ulcer is localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear. - LOINC 72527-5 (Pressure ulcer stage NPUAP)"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.evaluationComponent.pressureUlcerStage"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-PressureUlcerStage-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.evaluationComponent.visibleStructure"> <path value="fsw-WoundAssessment-model.evaluationComponent.visibleStructure"/> <code> <system value="http://loinc.org"/> <code value="89250-5"/> </code> <short value="Exposed body structures, devices, and/or foreign bodies visible by the naked eye in a wound. - LOINC 89250-5 (Device or anatomic structure visible in wound)"/> <definition value="Exposed body structures, devices, and/or foreign bodies visible by the naked eye in a wound. - LOINC 89250-5 (Device or anatomic structure visible in wound)"/> <min value="0"/> <max value="*"/> <base> <path value="fsw-WoundAssessment-model.evaluationComponent.visibleStructure"/> <min value="0"/> <max value="*"/> </base> <type> <code value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-VisibleStructure-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.evaluationComponent.woundHealingAssessment"> <path value="fsw-WoundAssessment-model.evaluationComponent.woundHealingAssessment"/> <code> <system value="http://loinc.org"/> <code value="80338-7"/> </code> <short value="- LOINC 80338-7 (Wound assessment [Interpretation])"/> <definition value="- LOINC 80338-7 (Wound assessment [Interpretation])"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.evaluationComponent.woundHealingAssessment"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-WoundHealingAssessment-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.evaluationComponent.woundTrend"> <path value="fsw-WoundAssessment-model.evaluationComponent.woundTrend"/> <code> <system value="http://loinc.org"/> <code value="89253-9"/> </code> <short value="Whether a condition is improving, worsening, stable, or resolved. - LOINC 89253-9 (Trend)"/> <definition value="Whether a condition is improving, worsening, stable, or resolved. - LOINC 89253-9 (Trend)"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.evaluationComponent.woundTrend"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-WoundTrend-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.interpretation"> <path value="fsw-WoundAssessment-model.interpretation"/> <short value="Description"/> <definition value="Description"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.interpretation"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.method"> <path value="fsw-WoundAssessment-model.method"/> <short value="Description"/> <definition value="Description"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.method"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.resultStatus"> <path value="fsw-WoundAssessment-model.resultStatus"/> <short value="Description"/> <definition value="Description"/> <min value="1"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.resultStatus"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <strength value="required"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-status"/> </valueSetReference> </binding> </element> <element id="fsw-WoundAssessment-model.panelMembers"> <path value="fsw-WoundAssessment-model.panelMembers"/> <short value="PanelMembers represent the elements of a group of a related but independent evaluations."/> <definition value="PanelMembers represent the elements of a group of a related but independent evaluations. Examples are the measurements that compose a complete blood count (CBC), or the elements of a pathology report. Each member is an independent evaluation, but the grouping reflects a composite lab order, shared specimen, or a single report author. Typically the Category and Reason are not given for individual findings that are part of the panel, but rather given at the level of the panel itself."/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.panelMembers"/> <min value="0"/> <max value="1"/> </base> <type> <code value="BackboneElement"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.panelMembers.observationStatement"> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement"/> <short value="A base class for representing observed facts, including provenance"/> <definition value="A base class for representing observed facts, including provenance"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement"/> <min value="0"/> <max value="1"/> </base> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.panelMembers.observationStatement.woundAssertion"> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundAssertion"/> <code> <system value="http://loinc.org"/> <code value="72287-6"/> <display value="LNC#72287-6"/> </code> <short value="Assertion of the existence of a wound on a patient"/> <definition value="Assertion of the existence of a wound on a patient"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundAssertion"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-WoundAssertion-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.panelMembers.observationStatement.woundBed"> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundBed"/> <code> <system value="http://loinc.org"/> <code value="72287-6"/> <display value="LNC#72287-6"/> </code> <short value="- LOINC 72372-6 (Wound bed and edge panel)"/> <definition value="- LOINC 72372-6 (Wound bed and edge panel)"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundBed"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-WoundBed-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.panelMembers.observationStatement.woundEdge"> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundEdge"/> <code> <system value="http://loinc.org"/> <code value="72287-6"/> <display value="LNC#72287-6"/> </code> <short value="- LOINC 89256-2 (Wound edge panel)"/> <definition value="- LOINC 89256-2 (Wound edge panel)"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundEdge"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-WoundEdge-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.panelMembers.observationStatement.woundExudate"> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundExudate"/> <code> <system value="http://loinc.org"/> <code value="72287-6"/> <display value="LNC#72287-6"/> </code> <short value="- LOINC 72292-6 (Wound exudate panel)"/> <definition value="- LOINC 72292-6 (Wound exudate panel)"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundExudate"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-WoundExudate-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.panelMembers.observationStatement.woundSize"> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundSize"/> <code> <system value="http://loinc.org"/> <code value="72287-6"/> <display value="LNC#72287-6"/> </code> <short value="- LOINC 72287-6 (Wound size panel)"/> <definition value="- LOINC 72287-6 (Wound size panel)"/> <min value="0"/> <max value="1"/> <base> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundSize"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-WoundSize-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.panelMembers.observationStatement.woundTunneling"> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundTunneling"/> <code> <system value="http://loinc.org"/> <code value="72287-6"/> <display value="LNC#72287-6"/> </code> <short value="LOINC 89257-0 (Wound tunneling panel)"/> <definition value="LOINC 89257-0 (Wound tunneling panel)"/> <min value="0"/> <max value="*"/> <base> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundTunneling"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-WoundTunneling-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="fsw-WoundAssessment-model.panelMembers.observationStatement.woundUndermining"> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundUndermining"/> <code> <system value="http://loinc.org"/> <code value="89258-8"/> <display value="LNC#89258-8"/> </code> <short value="LOINC 89258-8 (Wound undermining panel)"/> <definition value="LOINC 89258-8 (Wound undermining panel)"/> <min value="0"/> <max value="*"/> <base> <path value="fsw-WoundAssessment-model.panelMembers.observationStatement.woundUndermining"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/fsw/StructureDefinition/fsw-WoundUndermining-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> </differential> </StructureDefinition>