"An observation identifying a potential adverse outcome as a result of an Act or combination of Acts. Examples: Detection of a drug-drug interaction; Identification of a late-submission for an invoice; Requesting discharge for a patient who does not meet hospital-defined discharge criteria. Discussion: This class is commonly used for identifying 'business rule' or 'process' problems that may result in a refusal to carry out a particular request. In some circumstances it may be possible to 'bypass' a problem by modifying the request to acknowledge the issue and/or by providing some form of mitigation. Constraints: the Act or Acts that may cause the the adverse outcome are the target of a subject ActRelationship. The subbtypes of this concept indicate the type of problem being detected (e.g. drug-drug interaction) while the Observation.value is used to repesent a specific problem code (e.g. specific drug-drug interaction id)." - HL7 Version 3
"Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, Ineffective treatment frequency, Procedure-condition conflict, etc." - HL7 FHIR, DetectedIssue

Attributes
Participation	author	"Individual or device responsible for the issue being raised. For example, a decision support application or a pharmacist conducting a medication review." - HL7 FHIR, DetectedIssue.author
«CS» Code	category	"Identifies the general type of issue identified." - HL7 FHIR, DetectedIssue.code
«CS» Code	detectedIssue	Indicates the issue that was detected (also called an order check).
DetectedIssueOrderRevision	detectedIssueOrderRevision	Provides a record of a revision to the originally proposed Order Action - the resulting revision reflecting a decision to change the Order Action based on information presented by the Detected Issue (aka Order Check).
DetectedIssueOverride	detectedIssueOverride	Provides a record that the Detected Issue (or "Order Check") was acknowledged and was disregarded. For example, perhaps a warning was displayed indicating that the patient has a mild allergy to an antibiotic that the clinician wishes to order. If the antibiotic is the only one that could possibly save the patient's life, the clinician would likely choose to order the antibiotic anyway.
DetectedIssueEvidence	evidence	"Supporting evidence or manifestations that provide the basis for identifying the detected issue such as a GuidanceResponse or MeasureReport." - HL7 FHIR, DetectedIssue.evidence
«IVL_TS» Period	identified	"The date or period when the detected issue was initially identified." - HL7 FHIR, DetectedIssue.identified[x] Note that in FHIR, the datatype of this property can be either a dateTime or a Period. In FHIM, this is currently modeled as a Period.
«II» Id	identifier	"Business identifier associated with the detected issue record." - HL7 FHIR, DetectedIssue.identifier
«ANY» Any	implicated	"Indicates the resource representing the current activity or proposed activity that is potentially problematic." - HL7 FHIR, DetectedIssue.implicated Note that the FHIR DetectedIssue resource points to the problematic activity, whereas in the FHIM, the problematic activity generally points to the detected issue.
DetectedIssueMitigation	mitigation	"Indicates an action that has been taken or is committed to to reduce or eliminate the likelihood of the risk identified by the detected issue from manifesting. Can also reflect an observation of known mitigating factors that may reduce/eliminate the need for any action." - HL7 FHIR, DetectedIssue.mitigation
String	reference	"The literature, knowledge-base or similar reference that describes the propensity for the detected issue identified." - HL7 FHIR, DetectedIssue.reference
«CS» Code	severity	The clinical danger level associated with this detected issue. Those having a High danger level will require a justification for override and release. Valid values are High, Moderate, or Low. "Indicates the degree of importance associated with the identified issue based on the potential impact on the patient." - HL7 FHIR, DetectedIssue.severity
«CS» Code	status	"Indicates the status of the detected issue." - HL7 FHIR, DetectedIssue.status
String	text	Contains the actual text of the detected issue. "A textual explanation of the detected issue." - HL7 FHIR, DetectedIssue.detail

 author

Public Participation author

"Individual or device responsible for the issue being raised. For example, a decision support application or a pharmacist conducting a medication review." - HL7 FHIR, DetectedIssue.author

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	DetectedIssueEvent
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	author
Name Expression
Namespace	DetectedIssueEvent
Opposite
Owner	DetectedIssueEvent
Owning Association
Owning Template Parameter
Qualified Name	FHIM::Orders::DetectedIssueEvent::author
Stereotype
Template Parameter
Type	Participation
Upper	1
Upper Value	(1)
Visibility	Public

 category

Public «CS» Code category

"Identifies the general type of issue identified." - HL7 FHIR, DetectedIssue.code

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	DetectedIssueEvent
Terminologies	[ HL7_FHIR_R4 Detected Issue Category http://hl7.org/fhir/ValueSet/detectedissue-category ]
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	category
Name Expression
Namespace	DetectedIssueEvent
Opposite
Owner	DetectedIssueEvent
Owning Association
Owning Template Parameter
Qualified Name	FHIM::Orders::DetectedIssueEvent::category
Stereotype	ValueSetConstraints
Template Parameter
Type	«CS» Code
Upper	1
Upper Value	(1)
Visibility	Public

 detectedIssue

Public «CS» Code detectedIssue

Indicates the issue that was detected (also called an order check).

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	DetectedIssueEvent
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	1
Lower Value	(1)
Multiplicity	1
Name	detectedIssue
Name Expression
Namespace	DetectedIssueEvent
Opposite
Owner	DetectedIssueEvent
Owning Association
Owning Template Parameter
Qualified Name	FHIM::Orders::DetectedIssueEvent::detectedIssue
Stereotype
Template Parameter
Type	«CS» Code
Upper	1
Upper Value	(1)
Visibility	Public

 detectedIssueOrderRevision

Public DetectedIssueOrderRevision detectedIssueOrderRevision

Provides a record of a revision to the originally proposed Order Action - the resulting revision reflecting a decision to change the Order Action based on information presented by the Detected Issue (aka Order Check).

Constraints:

Properties:

Aggregation	None
Alias
Association	detectedIssueEvent_detectedIssueOrderRevision
Association End
Class	DetectedIssueEvent
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	detectedIssueOrderRevision
Name Expression
Namespace	DetectedIssueEvent
Opposite
Owner	DetectedIssueEvent
Owning Association
Owning Template Parameter
Qualified Name	FHIM::Orders::DetectedIssueEvent::detectedIssueOrderRevision
Stereotype
Template Parameter
Type	DetectedIssueOrderRevision
Upper	1
Upper Value	(1)
Visibility	Public

 detectedIssueOverride

Public DetectedIssueOverride detectedIssueOverride

Provides a record that the Detected Issue (or "Order Check") was acknowledged and was disregarded. For example, perhaps a warning was displayed indicating that the patient has a mild allergy to an antibiotic that the clinician wishes to order. If the antibiotic is the only one that could possibly save the patient's life, the clinician would likely choose to order the antibiotic anyway.

Constraints:

Properties:

Aggregation	None
Alias
Association	detectedIssueEvent_dectectedIssueOverride
Association End
Class	DetectedIssueEvent
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	detectedIssueOverride
Name Expression
Namespace	DetectedIssueEvent
Opposite
Owner	DetectedIssueEvent
Owning Association
Owning Template Parameter
Qualified Name	FHIM::Orders::DetectedIssueEvent::detectedIssueOverride
Stereotype
Template Parameter
Type	DetectedIssueOverride
Upper	1
Upper Value	(1)
Visibility	Public

 evidence

Public DetectedIssueEvidence evidence

"Supporting evidence or manifestations that provide the basis for identifying the detected issue such as a GuidanceResponse or MeasureReport." - HL7 FHIR, DetectedIssue.evidence

Constraints:

Properties:

Aggregation	None
Alias
Association	detectedIssueEvent_evidence
Association End
Class	DetectedIssueEvent
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	*
Name	evidence
Name Expression
Namespace	DetectedIssueEvent
Opposite
Owner	DetectedIssueEvent
Owning Association
Owning Template Parameter
Qualified Name	FHIM::Orders::DetectedIssueEvent::evidence
Stereotype
Template Parameter
Type	DetectedIssueEvidence
Upper	*
Upper Value	(*)
Visibility	Public

 identified

Public «IVL_TS» Period identified

"The date or period when the detected issue was initially identified." - HL7 FHIR, DetectedIssue.identified[x]
Note that in FHIR, the datatype of this property can be either a dateTime or a Period. In FHIM, this is currently modeled as a Period.

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	DetectedIssueEvent
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	identified
Name Expression
Namespace	DetectedIssueEvent
Opposite
Owner	DetectedIssueEvent
Owning Association
Owning Template Parameter
Qualified Name	FHIM::Orders::DetectedIssueEvent::identified
Stereotype
Template Parameter
Type	«IVL_TS» Period
Upper	1
Upper Value	(1)
Visibility	Public

 identifier

Public «II» Id identifier

"Business identifier associated with the detected issue record." - HL7 FHIR, DetectedIssue.identifier

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	DetectedIssueEvent
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	identifier
Name Expression
Namespace	DetectedIssueEvent
Opposite
Owner	DetectedIssueEvent
Owning Association
Owning Template Parameter
Qualified Name	FHIM::Orders::DetectedIssueEvent::identifier
Stereotype
Template Parameter
Type	«II» Id
Upper	1
Upper Value	(1)
Visibility	Public

 implicated

Public «ANY» Any implicated

"Indicates the resource representing the current activity or proposed activity that is potentially problematic." - HL7 FHIR, DetectedIssue.implicated
Note that the FHIR DetectedIssue resource points to the problematic activity, whereas in the FHIM, the problematic activity generally points to the detected issue.

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	DetectedIssueEvent
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	*
Name	implicated
Name Expression
Namespace	DetectedIssueEvent
Opposite
Owner	DetectedIssueEvent
Owning Association
Owning Template Parameter
Qualified Name	FHIM::Orders::DetectedIssueEvent::implicated
Stereotype
Template Parameter
Type	«ANY» Any
Upper	*
Upper Value	(*)
Visibility	Public

 mitigation

Public DetectedIssueMitigation mitigation

"Indicates an action that has been taken or is committed to to reduce or eliminate the likelihood of the risk identified by the detected issue from manifesting. Can also reflect an observation of known mitigating factors that may reduce/eliminate the need for any action." - HL7 FHIR, DetectedIssue.mitigation

Constraints:

Properties:

Aggregation	None
Alias
Association	detectedIssueEvent_detectedIssueMitigation
Association End
Class	DetectedIssueEvent
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	*
Name	mitigation
Name Expression
Namespace	DetectedIssueEvent
Opposite
Owner	DetectedIssueEvent
Owning Association
Owning Template Parameter
Qualified Name	FHIM::Orders::DetectedIssueEvent::mitigation
Stereotype
Template Parameter
Type	DetectedIssueMitigation
Upper	*
Upper Value	(*)
Visibility	Public

 reference

Public String reference

"The literature, knowledge-base or similar reference that describes the propensity for the detected issue identified." - HL7 FHIR, DetectedIssue.reference

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	DetectedIssueEvent
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	reference
Name Expression
Namespace	DetectedIssueEvent
Opposite
Owner	DetectedIssueEvent
Owning Association
Owning Template Parameter
Qualified Name	FHIM::Orders::DetectedIssueEvent::reference
Stereotype
Template Parameter
Type	String
Upper	1
Upper Value	(1)
Visibility	Public

 severity

Public «CS» Code severity

The clinical danger level associated with this detected issue. Those having a High danger level will require a justification for override and release. Valid values are High, Moderate, or Low.
"Indicates the degree of importance associated with the identified issue based on the potential impact on the patient." - HL7 FHIR, DetectedIssue.severity

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	DetectedIssueEvent
Terminologies	[ HL7_FHIR_R4 DetectedIssueSeverity http://hl7.org/fhir/ValueSet/detectedissue-severity ]
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	severity
Name Expression
Namespace	DetectedIssueEvent
Opposite
Owner	DetectedIssueEvent
Owning Association
Owning Template Parameter
Qualified Name	FHIM::Orders::DetectedIssueEvent::severity
Stereotype	ValueSetConstraints
Template Parameter
Type	«CS» Code
Upper	1
Upper Value	(1)
Visibility	Public

 status

Public «CS» Code status

"Indicates the status of the detected issue." - HL7 FHIR, DetectedIssue.status

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	DetectedIssueEvent
Terminologies	[ HL7_FHIR_R4 ObservationStatus http://hl7.org/fhir/ValueSet/observation-status ]
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	1
Lower Value	(1)
Multiplicity	1
Name	status
Name Expression
Namespace	DetectedIssueEvent
Opposite
Owner	DetectedIssueEvent
Owning Association
Owning Template Parameter
Qualified Name	FHIM::Orders::DetectedIssueEvent::status
Stereotype	ValueSetConstraints
Template Parameter
Type	«CS» Code
Upper	1
Upper Value	(1)
Visibility	Public

 text

Public String text

Contains the actual text of the detected issue.
"A textual explanation of the detected issue." - HL7 FHIR, DetectedIssue.detail

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	DetectedIssueEvent
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	1
Lower Value	(1)
Multiplicity	1
Name	text
Name Expression
Namespace	DetectedIssueEvent
Opposite
Owner	DetectedIssueEvent
Owning Association
Owning Template Parameter
Qualified Name	FHIM::Orders::DetectedIssueEvent::text
Stereotype
Template Parameter
Type	String
Upper	1
Upper Value	(1)
Visibility	Public